Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | N2630 | NY |
N | 213ES0103X | Foot & Ankle Surgery | N2630 | NY |
NPI | 1598762437 |
---|---|
Provider Name | Dr. Edwin William Wolf |
First Address | New York, NY 10024 |
Second Address | New York, NY 10024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 06/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00405005 | (05) | NY |
T50861 | (02) |