Individual
LARRY WOLK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
970 HOOPER AVE # 2, TOMS RIVER, NJ 08753-8319
(732) 228-4146
(732) 504-7104
Mailing address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 273-4300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD020175E
PA
208600000X
Surgery Physician
Primary
25MA04463400
NJ
208600000X
Surgery Physician
MD020175E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000966226
—
PA
01
—
0030929000
INDEPENDENCE BLUE CROSS
PA
01
—
0096622605
AMERICHOICE
PA
01
—
10880
BRAVO ELDER HEALTH
PA
01
—
13361
HEALTH PARTNERS
PA
01
—
20018648
RR MEDICARE
PA
Enumeration date
09/07/2005
Last updated
03/08/2023
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