Individual
DAN ANTONESCU WOLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
989 W JERICHO TPKE, SMITHTOWN, NY 11787
(631) 864-7100
(631) 864-7129
Mailing address
989 W JERICHO TPKE, SMITHTOWN, NY 11787
(631) 864-7100
(631) 864-7129
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
152817
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00894564
—
NY
01
—
0118403
GHI
NY
01
—
P00354563
RAILROAD MEDICARE
—
Enumeration date
08/04/2006
Last updated
06/02/2008
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