Healthcare Provider Details

I. General information

NPI: 1811258353
Provider Name (Legal Business Name): ANN WOJTASZCZYK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2012
Last Update Date: 05/06/2022
Certification Date: 05/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 3RD AVE FL 6
NEW YORK NY
10022-6630
US

IV. Provider business mailing address

50 S B B KING BLVD STE 100
MEMPHIS TN
38103-2626
US

V. Phone/Fax

Practice location:
  • Phone: 866-949-0108
  • Fax:
Mailing address:
  • Phone: 929-240-0279
  • Fax: 866-619-1923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number278168
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: