Provider Demographics
NPI:1700088341
Name:WOJTKOWSKI, JENNIFER M (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:M
Last Name:WOJTKOWSKI
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:MISS
Other - First Name:JENNIFER
Other - Middle Name:M
Other - Last Name:SLONSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:165 TOR CT
Mailing Address - Street 2:BERKSHIRE MEDICAL CENTER HILLCREST CAMPUS
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201
Mailing Address - Country:US
Mailing Address - Phone:413-447-2000
Mailing Address - Fax:413-445-9326
Practice Address - Street 1:165 TOR CT
Practice Address - Street 2:OPERATION BETTER START
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-3001
Practice Address - Country:US
Practice Address - Phone:413-447-2000
Practice Address - Fax:413-445-9326
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA959741133V00000X
MA949741133VN1004X
MA2583133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133N00000XDietary & Nutritional Service ProvidersNutritionist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2583OtherMA LICENSE