Provider Demographics
NPI:1033177357
Name:WOLFSON, HELEN ANNE (MD, LLC)
Entity Type:Individual
Prefix:DR
First Name:HELEN
Middle Name:ANNE
Last Name:WOLFSON
Suffix:
Gender:F
Credentials:MD, LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1088 W BALTIMORE PIKE
Mailing Address - Street 2:HCC II STE 2202
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5136
Mailing Address - Country:US
Mailing Address - Phone:610-566-5970
Mailing Address - Fax:610-566-3387
Practice Address - Street 1:1088 W BALTIMORE PIKE
Practice Address - Street 2:HCC II STE 2202
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5136
Practice Address - Country:US
Practice Address - Phone:610-566-5970
Practice Address - Fax:610-566-3387
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053143L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0243843000OtherIBC - INDIVIDUAL NUMBER
PA1863656OtherHIGHMARK AA
PA2724960001OtherIBC - GROUP NUMBER
PA00172888200231Medicaid
PA994023OtherHIGHMARK INDIVIDUAL NUM
PA00172888200231Medicaid
PA0243843000OtherIBC - INDIVIDUAL NUMBER