Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 22D101602300 | NJ |
Y | 213EG0000X | General Practice | 22D101602300 | NJ |
NPI | 1003937293 |
---|---|
Provider Name | Dr. Hal S Wolfson |
First Address | Clifton, NJ 07012-2404 |
Second Address | Clifton, NJ 07012-2404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/07/2007 |