Provider Demographics
NPI:1528007572
Name:ALBERT WOLKOFF,M.D.,P.C.
Entity Type:Organization
Organization Name:ALBERT WOLKOFF,M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-722-1170
Mailing Address - Street 1:20 HAWLEY ST
Mailing Address - Street 2:6TH FLOOR WEST TOWER
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-3216
Mailing Address - Country:US
Mailing Address - Phone:607-722-1170
Mailing Address - Fax:607-722-7559
Practice Address - Street 1:20 HAWLEY ST
Practice Address - Street 2:6TH FLOOR WEST TOWER
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-3216
Practice Address - Country:US
Practice Address - Phone:607-722-1170
Practice Address - Fax:607-722-7559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1073482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00597008Medicaid
NY32806BMedicare ID - Type Unspecified
NY00597008Medicaid