Individual provider Active NPI

Abigail C. Wolfson, CPNP

  • Pediatric Nurse Practitioner
  • Brooklyn, NY
National Provider Identifier
1528253010
Registry record updated Sep 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
381807 Issued in NY
Practice address
610 Henry St
PS 146, Lich Clinic, Room 209
Brooklyn, NY 11231-2612
Phone
(718) 923-4624
Fax
(718) 923-4632
NPI assigned
Sep 8, 2007
Last updated
Sep 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 381807 NY Primary

Addresses

Primary practice location

610 Henry St
PS 146, Lich Clinic, Room 209
Brooklyn, NY 11231-2612

Mailing address

610 Henry St
PS 146, Lich Clinic, Room 209
Brooklyn, NY 11231-2612
Phone (718) 923-4624

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)
Not enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
381807NYMDPediatric Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189209600000",
    "number": "1528253010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 HENRY ST",
            "address_2": "PS 146, LICH CLINIC, ROOM 209",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112312612",
            "telephone_number": "718-923-4624",
            "fax_number": "718-923-4632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 HENRY ST",
            "address_2": "PS 146, LICH CLINIC, ROOM 209",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112312612",
            "telephone_number": "718-923-4624",
            "fax_number": "718-923-4632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFSON",
        "first_name": "ABIGAIL",
        "middle_name": "C.",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-08",
        "last_updated": "2007-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "381807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.