Mr. Eric R Wolf
Dermatologist
495 Gold Star Hwy Suite 108
Groton
, Connecticut 06340-6228
Mr. Eric R Wolf
Dermatologist
495 Gold Star Hwy Suite 108
Groton
, Connecticut 06340-6228
(860) 445-7246
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About
Features
Specialties
- Dermatologist
Languages spoken
- English
Location
First Address
- Mr. Eric R Wolf
- 495 Gold Star Hwy Suite 108
- Groton, CT
- Zip : 06340-6228
- Fax : (860) 445-7246
- Phone : (860) 449-9090
Second Address
- Mr. Eric R Wolf
- 495 Gold Star Hwy Suite 108
- Groton, CT
- Zip : 06340-6228
- Fax : (860) 445-7246
- Phone : (860) 449-9090
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207N00000X | Dermatologist | 023620 | CT |
National Provider Identifier
| NPI | 1043308885 |
|---|---|
| Provider Name | Mr. Eric R Wolf |
| First Address | Groton, CT 06340-6228 |
| Second Address | Groton, CT 06340-6228 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/10/2006 |
| Last Update Date | 28/09/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1236207 | (05) | CT |
| B39125 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.