MEDICARE: CHRISTIN WOLAK PA-C

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	363A00000X	Physician Assistant	PA4076	MA

General Provider Information

NPI Number	:	1831499383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIN WOLAK PA-C

Provider Business Mailing Address
First Line	:	300 BIRNIE AVE STE 201
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01107-1121
Country	:	US
Telephone Number	:	413-785-4666
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 BIRNIE AVE STE 201
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01107-1121
Country	:	US
Telephone Number	:	413-785-4666
Fax Number	:

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

Provider Enumeration Date	:	11/01/2010
Last Update Date	:	01/29/2024

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