Provider Demographics
NPI:1508322801
Name:JOSHUA D. WOLPERT M.D.
Entity Type:Organization
Organization Name:JOSHUA D. WOLPERT M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLPERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-800-3201
Mailing Address - Street 1:105 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:BRIELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08730-1813
Mailing Address - Country:US
Mailing Address - Phone:732-800-3201
Mailing Address - Fax:732-800-3203
Practice Address - Street 1:105 UNION AVE
Practice Address - Street 2:
Practice Address - City:BRIELLE
Practice Address - State:NJ
Practice Address - Zip Code:08730-1813
Practice Address - Country:US
Practice Address - Phone:732-800-3201
Practice Address - Fax:732-800-3203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-12
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty