Provider Demographics
NPI:1457663056
Name:WOHLSTADTER, JOHANNA (AUD)
Entity Type:Individual
Prefix:DR
First Name:JOHANNA
Middle Name:
Last Name:WOHLSTADTER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 2ND AVE
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-5615
Mailing Address - Country:US
Mailing Address - Phone:646-438-7879
Mailing Address - Fax:
Practice Address - Street 1:380 2ND AVE
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5615
Practice Address - Country:US
Practice Address - Phone:646-438-7879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002297-1231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist