Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 216438 | NY |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 216438 | NY |
NPI | 1396702023 |
---|---|
Provider Name | Dr. Warren E Wulff |
First Address | Syracuse, NY 13214-1880 |
Second Address | De Witt, NY 13214-1880 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 06/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H14197 | (02) |