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NPI Code Detail

MEDICARE: EMILY KATE WOLF PA

MEDICARE: EMILY KATE WOLF PA
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 Program
2363A00000XPhysician Assistant50.009546RXOH

General Provider Information

NPI Number : 1609763002
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY KATE WOLF PA
Provider Business Mailing Address
First Line : 3335 W 130TH ST LOWR
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-2508
Country : US
Telephone Number : 815-374-0380
Fax Number :
Provider Business Practice Location Address
First Line : 3335 W 130TH ST LOWR
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-2508
Country : US
Telephone Number : 815-374-0380
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2025
Last Update Date : 06/27/2025

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Directions to “ EMILY KATE WOLF PA” Practice Location

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