Provider Demographics
NPI:1972554624
Name:WOLF, JUDITH E (MD)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:E
Last Name:WOLF
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1601 CHERRY ST
Mailing Address - Street 2:SUITE 11511
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1321
Mailing Address - Country:US
Mailing Address - Phone:215-255-7822
Mailing Address - Fax:215-255-7825
Practice Address - Street 1:219 N BROAD ST
Practice Address - Street 2:5TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-1519
Practice Address - Country:US
Practice Address - Phone:215-762-6555
Practice Address - Fax:215-762-3031
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2013-08-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PWMD-028048E207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001100790Medicaid
PA001100790Medicaid
PAC33554Medicare UPIN