Provider Demographics
NPI:1750561965
Name:WOLF, PASCAL DEVIR (PSYD)
Entity type:Individual
Prefix:MR
First Name:PASCAL
Middle Name:DEVIR
Last Name:WOLF
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1461A 1ST AVE STE 315
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-2201
Mailing Address - Country:US
Mailing Address - Phone:212-537-6813
Mailing Address - Fax:212-655-4459
Practice Address - Street 1:343 E 78TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1315
Practice Address - Country:US
Practice Address - Phone:212-537-6813
Practice Address - Fax:212-655-4459
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018453103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist