MEDICARE: PATRICIA WOLFSON PT

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	225100000X	Physical Therapist	40QA01284400	NJ

General Provider Information

NPI Number	:	1508218728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA WOLFSON PT

Provider Business Mailing Address
First Line	:	140 BOULEVARD
Second Line	:
City	:	WASHINGTON
State	:	NJ
Zip	:	07882-1761
Country	:	US
Telephone Number	:	908-689-3800
Fax Number	:	908-689-3844

Provider Business Practice Location Address
First Line	:	140 BOULEVARD
Second Line	:
City	:	WASHINGTON
State	:	NJ
Zip	:	07882-1761
Country	:	US
Telephone Number	:	908-689-3800
Fax Number	:	908-689-3844

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

Provider Enumeration Date	:	07/12/2016
Last Update Date	:	07/12/2016

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