Provider Demographics
NPI:1821674920
Name:WOLFERS, ANNIE CHAU (MD)
Entity type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:CHAU
Last Name:WOLFERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 ORANGE RD
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-4310
Mailing Address - Country:US
Mailing Address - Phone:862-213-0769
Mailing Address - Fax:
Practice Address - Street 1:314 ORANGE RD
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-4310
Practice Address - Country:US
Practice Address - Phone:862-213-0769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-20
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA12134400208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics