Provider Demographics
NPI:1003324708
Name:VERDINER, WOLF (RN)
Entity Type:Individual
Prefix:MR
First Name:WOLF
Middle Name:
Last Name:VERDINER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-5507
Mailing Address - Country:US
Mailing Address - Phone:347-225-0579
Mailing Address - Fax:
Practice Address - Street 1:418 GROVE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-5507
Practice Address - Country:US
Practice Address - Phone:347-225-0579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY742215163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse