Provider Demographics
NPI:1164405585
Name:WOJCIK, JAN B (MD)
Entity Type:Individual
Prefix:DR
First Name:JAN
Middle Name:B
Last Name:WOJCIK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:TRINITY HEALTH OF NE MED GRP - ATTN: PGREANEY
Mailing Address - Street 2:395 SOUTHAMPTON RD #100
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-1324
Mailing Address - Country:US
Mailing Address - Phone:413-485-4663
Mailing Address - Fax:413-562-1605
Practice Address - Street 1:175 CAREW STREET
Practice Address - Street 2:SUITE 110
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104
Practice Address - Country:US
Practice Address - Phone:413-732-4269
Practice Address - Fax:413-785-4619
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2018-10-11
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Provider Licenses
StateLicense IDTaxonomies
MA72523208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA62128335Medicaid
D02914Medicare UPIN
MAJ10147Medicare PIN
280000959Medicare PIN