Provider Demographics
NPI:1063597581
Name:WOLF, ROBERT IRWIN (PSYCHOANALYST)
Entity type:Individual
Prefix:PROF
First Name:ROBERT
Middle Name:IRWIN
Last Name:WOLF
Suffix:
Gender:M
Credentials:PSYCHOANALYST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 W 43RD ST
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-5305
Mailing Address - Country:US
Mailing Address - Phone:212-262-0746
Mailing Address - Fax:
Practice Address - Street 1:529 W 42ND ST
Practice Address - Street 2:APT. 2L
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-6220
Practice Address - Country:US
Practice Address - Phone:212-760-0287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000075103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis