Healthcare Provider Details

I. General information

NPI: 1043121890
Provider Name (Legal Business Name): HAILEY NILSON WOJCIK PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

681 CLARKSON AVE
BROOKLYN NY
11203-2125
US

IV. Provider business mailing address

681 CLARKSON AVE UNIT 11
BROOKLYN NY
11203-2125
US

V. Phone/Fax

Practice location:
  • Phone: 917-300-8158
  • Fax:
Mailing address:
  • Phone: 917-300-8158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number028406
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: