Healthcare Provider Details

I. General information

NPI: 1699029819
Provider Name (Legal Business Name): SUSAN GRACE WOJCINSKI (ADULT) N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2012
Last Update Date: 11/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3595 STATE SCHOOL RD
ALBION NY
14411-9399
US

IV. Provider business mailing address

3595 STATE SCHOOL RD
ALBION NY
14411-9399
US

V. Phone/Fax

Practice location:
  • Phone: 585-589-5511
  • Fax: 585-589-7770
Mailing address:
  • Phone: 585-589-5511
  • Fax: 585-589-7770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF300436-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: