Individual
ANDREA WOLF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 632-6000
Mailing address
100 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 632-6000
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/06/2021
Last updated
07/22/2021
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