Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 6316 | CT |
Y | 225100000X | Physical Therapist | 6316 | CT |
NPI | 1033543285 |
---|---|
Provider Name | Anne Wolf |
First Address | Fairfield, CT 06825-1734 |
Second Address | Trumbull, CT 06611-6337 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2013 |
Last Update Date | 13/05/2015 |