Provider Demographics
NPI:1649599606
Name:WOJACZEK, BARBARA KATARZYNA (PT)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:KATARZYNA
Last Name:WOJACZEK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SMITHTOWN BLVD
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-5115
Mailing Address - Country:US
Mailing Address - Phone:631-356-2412
Mailing Address - Fax:
Practice Address - Street 1:100 SMITHTOWN BLVD
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-5115
Practice Address - Country:US
Practice Address - Phone:631-356-2412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018081225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist