Provider Demographics
NPI:1407913569
Name:WOFSEY, ALAN ROSS (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:ROSS
Last Name:WOFSEY
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 1:100 E LANCASTER AVE
Mailing Address - Street 2:SUITE 566
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:610-649-3070
Mailing Address - Fax:610-527-7415
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:SUITE 566
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-649-3070
Practice Address - Fax:610-527-7415
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD017809E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAWO149459OtherBLUE SHIELD
PA0046483000OtherPERSONAL CHOICE
NY0111823002OtherGHI
PA0046483000OtherPERSONAL CHOICE
PA149459Medicare ID - Type Unspecified