Provider Demographics
NPI:1801952866
Name:WOLBRANSKY, HARVEY (OD)
Entity type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:
Last Name:WOLBRANSKY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6981 N PARK DR STE 101
Mailing Address - Street 2:COOPER RIVER SQUARE BLDG WEST
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-4201
Mailing Address - Country:US
Mailing Address - Phone:856-488-4404
Mailing Address - Fax:856-488-5207
Practice Address - Street 1:6981 N PARK DR STE 101
Practice Address - Street 2:COOPER RIVER SQUARE BLDG WEST
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109-4201
Practice Address - Country:US
Practice Address - Phone:856-488-4404
Practice Address - Fax:856-488-5207
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3730152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0072818000OtherAMERIHEALTH
1K8953OtherHEALTHNET
6807OtherDAVIS
96110OtherSPECTERA
NJ33091OtherAETNA
NJ2416905Medicaid
0072818000OtherAMERIHEALTH