Provider Demographics
NPI:1609087279
Name:WOLFE, JANET L (PHD)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:L
Last Name:WOLFE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 PARK AVE
Mailing Address - Street 2:16D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1759
Mailing Address - Country:US
Mailing Address - Phone:212-996-9326
Mailing Address - Fax:
Practice Address - Street 1:1235 PARK AVE
Practice Address - Street 2:16D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1759
Practice Address - Country:US
Practice Address - Phone:646-515-3130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY5197103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY163646OtherVALUE OPTIONS GHI
V25211Medicare ID - Type Unspecified