Provider Demographics
NPI:1548210016
Name:WOLFF, ALAN HARLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:HARLEY
Last Name:WOLFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MOUNTAIN BLVD
Mailing Address - Street 2:SUITE #3
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5650
Mailing Address - Country:US
Mailing Address - Phone:908-755-5335
Mailing Address - Fax:
Practice Address - Street 1:5 MOUNTAIN BLVD
Practice Address - Street 2:SUITE #3
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5650
Practice Address - Country:US
Practice Address - Phone:908-755-5335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 053908207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1289802Medicaid
NJMA 053908OtherSTATE MEDICAL LICENSE
NJD 05130100OtherCDS NUMBER
BW 0960838OtherDEA
NJMA 053908OtherSTATE MEDICAL LICENSE
NJ1289802Medicaid