Provider Demographics
NPI:1336427335
Name:WOLF, JENNIFER A (AUD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:A
Last Name:WOLF
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:A
Other - Last Name:KORT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD, CCC-A
Mailing Address - Street 1:1305 YORK AVE
Mailing Address - Street 2:HEARING AND SPEECH - 5TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-5663
Mailing Address - Country:US
Mailing Address - Phone:646-962-5446
Mailing Address - Fax:646-962-0431
Practice Address - Street 1:1305 YORK AVE
Practice Address - Street 2:HEARING AND SPEECH - 5TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5663
Practice Address - Country:US
Practice Address - Phone:646-962-5446
Practice Address - Fax:646-962-0431
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA954231H00000X
NY002404231H00000X
NY14000035414237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter