Provider Demographics
NPI:1871794214
Name:HOWARD M WOLHANDLER DPM PC
Entity type:Organization
Organization Name:HOWARD M WOLHANDLER DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:WOLHANDLER DPM
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:315-446-6282
Mailing Address - Street 1:3175 E GENESEE ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224-1613
Mailing Address - Country:US
Mailing Address - Phone:315-446-6282
Mailing Address - Fax:315-446-3491
Practice Address - Street 1:3175 E GENESEE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13224-1613
Practice Address - Country:US
Practice Address - Phone:315-446-6282
Practice Address - Fax:315-446-3491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002524 1213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0040Medicare PIN
NY0696980001Medicare NSC