Provider Demographics
NPI:1881998532
Name:WOLFE, BRIAN THOMAS (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:THOMAS
Last Name:WOLFE
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 OLD KINGS HWY N STE 13
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-4608
Mailing Address - Country:US
Mailing Address - Phone:914-960-4085
Mailing Address - Fax:203-475-9421
Practice Address - Street 1:349 POST RD
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-3606
Practice Address - Country:US
Practice Address - Phone:475-209-9420
Practice Address - Fax:475-209-9421
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12977225100000X
CT9580225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist