Provider Demographics
NPI:1275878696
Name:WOLFF, ALYSSA G
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:G
Last Name:WOLFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 E 39TH ST
Mailing Address - Street 2:APT 29M
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2187
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:330 E 39TH ST
Practice Address - Street 2:APT 29M
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2187
Practice Address - Country:US
Practice Address - Phone:315-246-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist