Provider Demographics
NPI:1881696185
Name:WOLF, EDWARD I (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:
Last Name:WOLF
Suffix:I
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 OLD SHORT HILLS RD
Mailing Address - Street 2:EAST WING, SUITE 402
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-5672
Mailing Address - Country:US
Mailing Address - Phone:973-322-5287
Mailing Address - Fax:973-322-2309
Practice Address - Street 1:94 OLD SHORT HILLS RD
Practice Address - Street 2:EAST WING, SUITE 402
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5672
Practice Address - Country:US
Practice Address - Phone:973-322-5287
Practice Address - Fax:973-322-2309
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06073400207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2996611OtherAETNA HMO
NJ8699975OtherGHI
NJP379112OtherOXFORD ID #
NJ0973202000OtherAMERIHEALTH
NJ6603009Medicaid
NJ1024513OtherHORIZON NJ HEALTH
NJ2K2136OtherHEALTHNET ID #
NJ4526244OtherAETNA PPO
NJ576E81OtherEMPIRE BC/BS OF NY ID #
NJ160059360OtherRAILROAD MCR
NJ28281OtherUHP
NJ8699975OtherGHI
NJ28281OtherUHP
NJH43494Medicare UPIN