Provider Demographics
NPI:1598865297
Name:WOOLRICH, AUDREY JANE (MD)
Entity Type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:JANE
Last Name:WOOLRICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 PARK AVE
Mailing Address - Street 2:FLOOR 1
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0913
Mailing Address - Country:US
Mailing Address - Phone:212-861-7441
Mailing Address - Fax:212-772-2877
Practice Address - Street 1:1020 PARK AVE
Practice Address - Street 2:FLOOR 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0913
Practice Address - Country:US
Practice Address - Phone:212-861-7441
Practice Address - Fax:212-772-2877
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2016-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY166434207RG0100X
FLME80312207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD92005Medicare UPIN
NY13F351Medicare ID - Type Unspecified