Provider Demographics
NPI:1447389838
Name:WOOLF, DEBRA (DC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:WOOLF
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 516
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08804-0516
Mailing Address - Country:US
Mailing Address - Phone:908-479-4788
Mailing Address - Fax:
Practice Address - Street 1:27 WILLOW AVE
Practice Address - Street 2:
Practice Address - City:BLOOMSBURY
Practice Address - State:NJ
Practice Address - Zip Code:08804-3120
Practice Address - Country:US
Practice Address - Phone:908-479-4788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00569200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ668756OtherCHIROPRACTOR
NJ0024376Medicaid
NJ1047366OtherCHIROPRACTOR
NJ077576Medicare ID - Type UnspecifiedCHIROPRACTOR