Provider Demographics
NPI:1982761748
Name:WOLDER, MARGARET (PHD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:WOLDER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W 86TH ST
Mailing Address - Street 2:SUITE 1J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3303
Mailing Address - Country:US
Mailing Address - Phone:212-724-8362
Mailing Address - Fax:
Practice Address - Street 1:200 W 86TH ST
Practice Address - Street 2:SUITE 1J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3303
Practice Address - Country:US
Practice Address - Phone:212-724-8362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009777-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV67451Medicare ID - Type Unspecified