Provider Demographics
NPI:1558908103
Name:WOLIN, TAYLOR F (DPT)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:F
Last Name:WOLIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 EDGERTON ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-3317
Mailing Address - Country:US
Mailing Address - Phone:585-507-9616
Mailing Address - Fax:
Practice Address - Street 1:238 EDGERTON ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-3317
Practice Address - Country:US
Practice Address - Phone:585-507-9616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038405-1261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy