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NPI Code Detail

MEDICARE: EMMA ROSE WOLFE

MEDICARE: EMMA ROSE 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
1390200000XStudent in an Organized Health Care Education/Training ProgramNY

General Provider Information

NPI Number : 1558220947
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMMA ROSE WOLFE
Provider Business Mailing Address
First Line : 760 BROADWAY
Second Line : DEPARTMENT OF DENTISTRY & OMS SUITE 2C-319
City : BROOKLYN
State : NY
Zip : 11206-5317
Country : US
Telephone Number : 718-963-8308
Fax Number : 718-963-8317
Provider Business Practice Location Address
First Line : 760 BROADWAY
Second Line : DEPARTMENT OF DENTISTRY & OMS SUITE 2C-319
City : BROOKLYN
State : NY
Zip : 11206-5317
Country : US
Telephone Number : 718-963-8308
Fax Number : 718-963-8317
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2026
Last Update Date : 01/20/2026

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