Provider Demographics
NPI:1528200722
Name:WOJTOVICH, RACHAEL (MD)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:
Last Name:WOJTOVICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59B MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-1308
Mailing Address - Country:US
Mailing Address - Phone:585-385-1710
Mailing Address - Fax:585-385-7718
Practice Address - Street 1:59B MONROE AVE
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-1308
Practice Address - Country:US
Practice Address - Phone:585-385-1710
Practice Address - Fax:585-385-7718
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262030208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics