Active NPI
Mendley A Wulfsohn, MD
- Urology Physician
- Clifton, NJ
National Provider Identifier
1114950797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 25MA37283
- Practice address
- 1033 Clifton Ave
Clifton, NJ 07013-3517 - Phone
- (973) 473-5700
- Fax
- (973) 473-3367
- NPI assigned
- Jul 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 25MA37283 | NJ | Primary |
Addresses
Primary practice location
1033 Clifton Ave
Clifton, NJ 07013-3517
Mailing address
1033 Clifton Ave
Clifton, NJ 07013
Phone (973) 473-5700
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0110272000 | Other | NJ | AMERIHEALTH ID# |
| 04A761 | Other | NJ | EMPIRE BCBS (CLIFTON) |
| 04A762 | Other | NJ | EMPIRE BCBS (WAYNE) |
| PS124 | Other | NJ | OXFORD ID# |
| 0028399 | Other | NJ | AETNA HMO# |
| 1000339 | Other | NJ | GHI PPO# |
| 0K2315 | Other | NJ | HEALTHNET ID# |
| 398357 | Other | NJ | WELLCARE |
| 4229231 | Other | NJ | AETNA PPO# |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA37283 | NJ | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208217600000",
"number": "1114950797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1033 CLIFTON AVE",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "07013",
"telephone_number": "973-473-5700",
"fax_number": "973-473-3367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1033 CLIFTON AVE",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070133517",
"telephone_number": "973-473-5700",
"fax_number": "973-473-3367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WULFSOHN",
"first_name": "MENDLEY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-08",
"last_updated": "2008-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "NJ",
"license": "25MA37283",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIHEALTH ID#",
"identifier": "0110272000",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BCBS (CLIFTON)",
"identifier": "04A761",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BCBS (WAYNE)",
"identifier": "04A762",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD ID#",
"identifier": "PS124",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO#",
"identifier": "0028399",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI PPO#",
"identifier": "1000339",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET ID#",
"identifier": "0K2315",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "398357",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PPO#",
"identifier": "4229231",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clifton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.