Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 135267 | NY |
NPI | 1073600037 |
---|---|
Provider Name | Dr. Robert R Wolff |
First Address | Waltham, MA 02453-2741 |
Second Address | Waltham, MA 02453-2741 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2006 |
Last Update Date | 18/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A62058 | (02) |