Healthcare Provider Details

I. General information

NPI: 1700088341
Provider Name (Legal Business Name): JENNIFER M WOJTKOWSKI R.D., L.D.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER M SLONSKI R.D., L.D.N.

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 03/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 TOR CT OPERATION BETTER START
PITTSFIELD MA
01201-3001
US

IV. Provider business mailing address

165 TOR CT BERKSHIRE MEDICAL CENTER HILLCREST CAMPUS
PITTSFIELD MA
01201
US

V. Phone/Fax

Practice location:
  • Phone: 413-447-2000
  • Fax: 413-445-9326
Mailing address:
  • Phone: 413-447-2000
  • Fax: 413-445-9326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number959741
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number949741
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number2583
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: