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Individual

EDWARD G WOLFE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPA

Contact information

Practice address
5100 W TAFT RD, SUITE 1C, LIVERPOOL, NY 13088-3807
(315) 452-2333
(315) 452-2336
Mailing address
5100 W TAFT RD, SUITE 1C, LIVERPOOL, NY 13088-3807
(315) 452-2333
(315) 452-2336

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0040681
NY
363A00000X
Physician Assistant
363AM0700X
Medical Physician Assistant
Primary
004068
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02366030
NY
Enumeration date
04/05/2006
Last updated
02/26/2019
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