Provider Demographics
NPI:1881811198
Name:WOLF, ANDREA SHARI (MD, MPH)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:SHARI
Last Name:WOLF
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1190 FIFTH AVE., BOX 1028
Mailing Address - Street 2:MOUNT SINAI MEDICAL CENTER
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-241-9502
Mailing Address - Fax:
Practice Address - Street 1:1190 FIFTH AVE., BOX 1028
Practice Address - Street 2:MOUNT SINAI MEDICAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-9502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY266642208G00000X
MA237754208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)