Provider Demographics
NPI:1639255094
Name:WOLF, LINDA D (MD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:D
Last Name:WOLF
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1635 CENTRAL AVENUE
Mailing Address - Street 2:ROOM 213
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06610
Mailing Address - Country:US
Mailing Address - Phone:203-551-7660
Mailing Address - Fax:203-551-7481
Practice Address - Street 1:1635 CENTRAL AVENUE
Practice Address - Street 2:SOUTHWEST CONNECTICUT MENTAL HEALTH SYSTEM
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610
Practice Address - Country:US
Practice Address - Phone:203-551-7660
Practice Address - Fax:203-551-7481
Is Sole Proprietor?:No
Enumeration Date:2006-10-28
Last Update Date:2025-09-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT0246372084P0800X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
D87336Medicare UPIN