Provider Demographics
NPI:1710200647
Name:WOJTOWICZ, JANICE M
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:M
Last Name:WOJTOWICZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 FRUITWOOD TER
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4745
Mailing Address - Country:US
Mailing Address - Phone:716-634-8990
Mailing Address - Fax:
Practice Address - Street 1:8672 BUFFALO AVE
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-4365
Practice Address - Country:US
Practice Address - Phone:716-283-8704
Practice Address - Fax:716-283-9521
Is Sole Proprietor?:No
Enumeration Date:2010-03-06
Last Update Date:2010-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042950183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist