Provider Demographics
NPI:1700848082
Name:WOOLF, NANCY SLATER (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:SLATER
Last Name:WOOLF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:101 CHESLEY DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-1761
Mailing Address - Country:US
Mailing Address - Phone:610-566-5056
Mailing Address - Fax:610-566-4686
Practice Address - Street 1:101 CHESLEY DR
Practice Address - Street 2:SUITE 201
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-1761
Practice Address - Country:US
Practice Address - Phone:610-566-5056
Practice Address - Fax:610-566-4686
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD067570L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB71741Medicare UPIN
PA035940Medicare ID - Type Unspecified