Provider Demographics
NPI:1073794624
Name:ROJEK, KATHLEEN ELAINE (RPH)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ELAINE
Last Name:ROJEK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 COLUMBIA DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6818
Mailing Address - Country:US
Mailing Address - Phone:716-633-6911
Mailing Address - Fax:
Practice Address - Street 1:5175 BROADWAY
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-4025
Practice Address - Country:US
Practice Address - Phone:716-515-3435
Practice Address - Fax:716-515-1101
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-23
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046902-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist