Individual
MR. JASON ANDREW WOLK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
26 WINDING PATH APT 15, MANORVILLE, NY 11949-2258
(516) 987-6607
Mailing address
26 WINDING PATH APT 15, MANORVILLE, NY 11949-2258
(516) 987-6607
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
528454-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02365731
—
NY
Enumeration date
05/19/2008
Last updated
05/19/2008
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