Provider Demographics
NPI:1851517056
Name:WOLFE, ROBERT DOLAN JR (AUD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:DOLAN
Last Name:WOLFE
Suffix:JR
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 S 7TH AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:WEST READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-1410
Mailing Address - Country:US
Mailing Address - Phone:610-376-6990
Mailing Address - Fax:610-376-6458
Practice Address - Street 1:301 S 7TH AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1410
Practice Address - Country:US
Practice Address - Phone:610-376-6990
Practice Address - Fax:610-376-6458
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000077L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02653400OtherCAPITAL BLUE CROSS
PA201834Medicare ID - Type Unspecified