Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 430207 | NY |
NPI | 1043326705 |
---|---|
Provider Name | Andrew Wolf |
First Address | Kendall, NY 14476 |
Second Address | Rochester, NY 14642-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 28/04/2021 |