Provider Demographics
NPI:1427103373
Name:JOSHUA D WOLPERT MD LLC
Entity type:Organization
Organization Name:JOSHUA D WOLPERT MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:D
Authorized Official - Last Name:WOLPERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-292-9044
Mailing Address - Street 1:87 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-3633
Mailing Address - Country:US
Mailing Address - Phone:732-292-9044
Mailing Address - Fax:732-292-9055
Practice Address - Street 1:87 UNION AVE
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-3633
Practice Address - Country:US
Practice Address - Phone:732-292-9044
Practice Address - Fax:732-292-9055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty