Healthcare Provider Details

I. General information

NPI: 1871629998
Provider Name (Legal Business Name): KATHLEEN ROSE WOJTOWICZ M.ED., CRC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 KENTON PL
HAMBURG NY
14075-4307
US

IV. Provider business mailing address

135 KENTON PL
HAMBURG NY
14075-4307
US

V. Phone/Fax

Practice location:
  • Phone: 716-648-7260
  • Fax: 716-648-7260
Mailing address:
  • Phone: 716-648-7260
  • Fax: 716-648-7260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: