Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 054585 | NY |
NPI | 1023270071 |
---|---|
Provider Name | Kirstin A Wolfe |
First Address | New York, NY 10016-5421 |
Second Address | New York, NY 10016-5421 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2008 |
Last Update Date | 28/08/2014 |