Provider Demographics
NPI:1295823466
Name:WOLKOFF, ALAN J (DC)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:J
Last Name:WOLKOFF
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 WEST PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-2118
Mailing Address - Country:US
Mailing Address - Phone:732-613-6000
Mailing Address - Fax:732-613-6007
Practice Address - Street 1:67 WEST PROSPECT ST
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-2118
Practice Address - Country:US
Practice Address - Phone:732-613-6000
Practice Address - Fax:732-613-6007
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC000405400111N00000X
FLCH6052111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ935690OtherAETNA HMO
NJ1037232OtherUNITED HEALTH CARE
407587Medicare ID - Type Unspecified
U37269Medicare UPIN