Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | 25MA07802900 | NJ |
N | 207RI0011X | Interventional Cardiology | MD428399 | PA |
NPI | 1073519336 |
---|---|
Provider Name | Andreas Wolf |
First Address | Newtown, PA 18940-3439 |
Second Address | Robbinsville, NJ 08691-4219 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 26/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3823193 | AETNA HMO # (01) | NJ |
7193107 | AETNA PPO # (01) | NJ |
G86411 | (02) | NJ |
P2797586 | OXFORD ID # (01) | NJ |