Healthcare Provider Details

I. General information

NPI: 1306048988
Provider Name (Legal Business Name): JENNIFER POHLMAN WOJNICKI PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 RANDALL TER
HAMBURG NY
14075-5312
US

IV. Provider business mailing address

77 RANDALL TER
HAMBURG NY
14075-5312
US

V. Phone/Fax

Practice location:
  • Phone: 716-646-6464
  • Fax:
Mailing address:
  • Phone: 716-646-6464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number012313-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: