Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VE0102X | Reproductive Endocrinologist | 168445 | NY |
Y | 207VE0102X | Reproductive Endocrinologist | 25MA05184600 | NJ |
N | 207VG0400X | Gynecologist | 168445 | NY |
NPI | 1427102110 |
---|---|
Provider Name | Dr. Susan A Wolf |
First Address | Hasbrouck Heights, NJ 07604 |
Second Address | Hasbrouck Heights, NJ 07604 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 12/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
GO1114 | (02) | NY |