Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 134114 | NY |
NPI | 1013000272 |
---|---|
Provider Name | Gisele Wolf-Klein |
First Address | Westbury, NY 11590-1740 |
Second Address | New Hyde Park, NY 11042-1008 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01148961 | (05) | NY |
D41797 | (02) |