Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 008827 | NY |
N | 111NI0013X | Independent Medical Examiner | X008827 | NY |
NPI | 1245700798 |
---|---|
Provider Name | Dr. Brian Eric Wolin |
First Address | Brooklyn, NY 11218-3305 |
Second Address | Brooklyn, NY 11218-3305 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2018 |
Last Update Date | 27/11/2018 |