Provider Demographics
NPI:1326262619
Name:WOLFSON, SAUL DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:SAUL
Middle Name:DAVID
Last Name:WOLFSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N BUCKSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-8310
Mailing Address - Country:US
Mailing Address - Phone:215-752-2828
Mailing Address - Fax:215-493-4787
Practice Address - Street 1:400 N BUCKSTOWN RD
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-8310
Practice Address - Country:US
Practice Address - Phone:215-752-2828
Practice Address - Fax:215-493-4787
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD010800E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC31130Medicare UPIN
PA130385Medicare ID - Type Unspecified