Provider Demographics
NPI:1245589399
Name:GREENE WOJDULA, BARBARA A (RN)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:A
Last Name:GREENE WOJDULA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9393 ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:ANGOLA
Mailing Address - State:NY
Mailing Address - Zip Code:14006-9225
Mailing Address - Country:US
Mailing Address - Phone:716-780-7313
Mailing Address - Fax:
Practice Address - Street 1:9393 ORANGE ST
Practice Address - Street 2:
Practice Address - City:ANGOLA
Practice Address - State:NY
Practice Address - Zip Code:14006-9225
Practice Address - Country:US
Practice Address - Phone:716-780-7313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY619609163W00000X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health