Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN0400X | Neurology | X010306-1 | NY |
N | 111NN1001X | Nutrition | X010306-1 | NY |
NPI | 1164542874 |
---|---|
Provider Name | Dr. Julie L.c. Wollen |
First Address | Orchard Park, NY 14127-2611 |
Second Address | Orchard Park, NY 14127-2611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 08/07/2007 |