MEDICARE: DR. BRIAN ERIC WOLIN DC

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	111NI0013X	Independent Medical Examiner Chiropractor	X008827	NY
2	111N00000X	Chiropractor	008827	NY

General Provider Information

NPI Number	:	1245700798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN ERIC WOLIN DC

Provider Business Mailing Address
First Line	:	717 CHURCH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-3305
Country	:	US
Telephone Number	:	718-421-4800
Fax Number	:	718-421-4815

Provider Business Practice Location Address
First Line	:	717 CHURCH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11218-3305
Country	:	US
Telephone Number	:	718-421-4800
Fax Number	:	718-421-4815

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

Provider Enumeration Date	:	11/27/2018
Last Update Date	:	11/27/2018

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