Lillian Ann Wolfe, FNP-C
Nurse Practitioner, Family in Southold, NY. Individual provider (NPI-1).
NPI number1184239014
StatusActive
Last updated in NPPESSep 16, 2024
Details
- NPI
- 1184239014
- Entity type
- Individual (NPI-1)
- Name
- Lillian Ann Wolfe
- Credential
- FNP-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 8, 2020
- Certification date
- Sep 16, 2024
- Last updated
- Sep 16, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | F346129-01 | NY | Yes |
| 363LF0000X | Nurse Practitioner, Family | 346129 | NY |
Other names
- Lillian Ann Blaszcyk (Former Name)
Practice location
57190 Main RdSouthold, NY 11971-4750
Phone 631-626-1006
Mailing address
4 Chip DrWading River, NY 11792-9541
Phone 631-495-4397
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