Provider Demographics
NPI:1346262235
Name:WOLKOFF, CHERYL E (AA)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:E
Last Name:WOLKOFF
Suffix:
Gender:F
Credentials:AA
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:E
Other - Last Name:ROTHENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AA
Mailing Address - Street 1:3605 WARRENSVILLE CENTER RD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:SHAKER HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5203
Mailing Address - Country:US
Mailing Address - Phone:216-286-6260
Mailing Address - Fax:216-286-6341
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-7330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH67-000033367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9205081OtherAETNA
OHP00385167OtherMEDICARE RAILROAD
OH000000225168OtherUNISON
OH415055OtherWELLCARE MEDICAID
OH2269496Medicaid
OHP00085096OtherRAILROAD MEDICARE
OH0583328OtherBCMH
OH000000515981OtherANTHEM
OHP00085096OtherRAILROAD MEDICARE
OHRO8208952Medicare PIN