Provider Demographics
NPI:1598813677
Name:WOLK, GARY NORMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:NORMAN
Last Name:WOLK
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1010 NORTHERN BLVD
Mailing Address - Street 2:SUITE208
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5306
Mailing Address - Country:US
Mailing Address - Phone:516-336-2555
Mailing Address - Fax:516-482-3624
Practice Address - Street 1:1010 NORTHERN BLVD
Practice Address - Street 2:SUITE208
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5306
Practice Address - Country:US
Practice Address - Phone:516-336-2555
Practice Address - Fax:516-482-3624
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2015-09-03
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Provider Licenses
StateLicense IDTaxonomies
NY1393032084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA96599Medicare UPIN