Provider Demographics
NPI:1497897110
Name:WOLLOWICK, ADAM LAURANCE (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:LAURANCE
Last Name:WOLLOWICK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3400 BAINBRIDGE AVE FL 6
Mailing Address - Street 2:ORTHOPAEDIC SURGERY
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2404
Mailing Address - Country:US
Mailing Address - Phone:718-920-5376
Mailing Address - Fax:718-654-2396
Practice Address - Street 1:3400 BAINBRIDGE AVE.
Practice Address - Street 2:MAP6, ORTHOPAEDIC SURGERY
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-5376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY225985207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine