MEDICARE: MR. DONALD PAUL WOLFE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	044946-1	NY

General Provider Information

NPI Number	:	1245415835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DONALD PAUL WOLFE

Provider Business Mailing Address
First Line	:	7020 108TH ST
Second Line	:	#3M
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-4449
Country	:	US
Telephone Number	:	718-268-6162
Fax Number	:	718-544-6119

Provider Business Practice Location Address
First Line	:	7020 108TH ST
Second Line	:	#3M
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-4449
Country	:	US
Telephone Number	:	718-268-6162
Fax Number	:	718-544-6119

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2008
Last Update Date	:	01/02/2008

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