Provider Demographics
NPI:1811904758
Name:WOLFSON, STEVEN (MS LAC)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:WOLFSON
Suffix:
Gender:M
Credentials:MS LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 140125
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:345 ROUTE 9 SOUTH
Practice Address - Street 2:#8
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726
Practice Address - Country:US
Practice Address - Phone:732-845-2200
Practice Address - Fax:732-845-0154
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00037100171100000X
NJ26NR12516600163WG0000X
NY569098163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice