Basic Information
Provider Information
NPI: 1700875473
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WOLF
FirstName: FRANCINE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1047 OLD YORK RD
Address2:  
City: ABINGTON
State: PA
PostalCode: 190014617
CountryCode: US
TelephoneNumber: 2158861240
FaxNumber: 2158867591
Practice Location
Address1: 1047 OLD YORK RD
Address2:  
City: ABINGTON
State: PA
PostalCode: 190014617
CountryCode: US
TelephoneNumber: 2158861240
FaxNumber: 2158867591
Other Information
ProviderEnumerationDate: 10/17/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200XUP002223DPAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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