Provider Demographics
NPI:1710760913
Name:WOLFF PODIATRY PLLC
Entity Type:Organization
Organization Name:WOLFF PODIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRY/BUSINESS OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLFF
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:713-702-2467
Mailing Address - Street 1:167 BEACH ST
Mailing Address - Street 2:
Mailing Address - City:DENNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02638-1817
Mailing Address - Country:US
Mailing Address - Phone:713-702-2467
Mailing Address - Fax:
Practice Address - Street 1:51 MAIN ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3109
Practice Address - Country:US
Practice Address - Phone:713-702-2467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty