Healthcare Provider Details

I. General information

NPI: 1659163053
Provider Name (Legal Business Name): DAVID A WOJTOWICZ PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 STERLING DR
ORCHARD PARK NY
14127-1566
US

IV. Provider business mailing address

4414 RICHWOOD DR
HAMBURG NY
14075-3936
US

V. Phone/Fax

Practice location:
  • Phone: 716-997-0868
  • Fax:
Mailing address:
  • Phone: 716-997-0868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number01225
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: