Provider Demographics
NPI:1952032765
Name:WOJNAR, ZACHARY TAYLOR (DPT)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:TAYLOR
Last Name:WOJNAR
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1643 98TH ST
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-2737
Mailing Address - Country:US
Mailing Address - Phone:716-531-1203
Mailing Address - Fax:
Practice Address - Street 1:4459 BAILEY AVE
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-2129
Practice Address - Country:US
Practice Address - Phone:716-835-2543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY203801756Medicaid