Provider Demographics
NPI:1619281334
Name:WOLFSON, AMY (OTR)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:WOLFSON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 BON AIR AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-3205
Mailing Address - Country:US
Mailing Address - Phone:914-654-1858
Mailing Address - Fax:914-654-2989
Practice Address - Street 1:38 BON AIR AVE
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10804-3205
Practice Address - Country:US
Practice Address - Phone:914-654-1858
Practice Address - Fax:914-654-2989
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002002-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist