Healthcare Provider Details

I. General information

NPI: 1700305364
Provider Name (Legal Business Name): KATARZYNA WOJDYLA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2017
Last Update Date: 09/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 W 44TH ST
NEW YORK NY
10036-5402
US

IV. Provider business mailing address

418 61ST ST APT 2A
BROOKLYN NY
11220-4506
US

V. Phone/Fax

Practice location:
  • Phone: 212-586-6400
  • Fax:
Mailing address:
  • Phone: 718-785-7127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number7135121
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: