Provider Demographics
NPI:1093915761
Name:WUJCIAK, DENISE ELAINE (ATC)
Entity Type:Individual
Prefix:MISS
First Name:DENISE
Middle Name:ELAINE
Last Name:WUJCIAK
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 E BROAD ST FL 3
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-2112
Mailing Address - Country:US
Mailing Address - Phone:908-233-2635
Mailing Address - Fax:
Practice Address - Street 1:KEAN UNIVERSITY
Practice Address - Street 2:1000 MORRIS AVENUE, D103
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083
Practice Address - Country:US
Practice Address - Phone:908-737-5450
Practice Address - Fax:908-737-5455
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MT000883002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer