Healthcare Provider Details

I. General information

NPI: 1427173657
Provider Name (Legal Business Name): WENDY MARIE GWOZDZ RPH, CDM, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

163 SOUTH ST
PITTSFIELD MA
01201-6805
US

IV. Provider business mailing address

163 SOUTH ST
PITTSFIELD MA
01201-6805
US

V. Phone/Fax

Practice location:
  • Phone: 413-445-5030
  • Fax: 413-448-8217
Mailing address:
  • Phone: 413-445-5030
  • Fax: 413-448-8217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19668
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: