Healthcare Provider Details

I. General information

NPI: 1225443831
Provider Name (Legal Business Name): AMY WUJASTYK THEIN PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMY LYNN WUJASTYK

II. Dates (important events)

Enumeration Date: 06/23/2014
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 CLINTON AVE S
ROCHESTER NY
14620-1448
US

IV. Provider business mailing address

142 PENARROW RD
ROCHESTER NY
14618-1724
US

V. Phone/Fax

Practice location:
  • Phone: 585-279-4800
  • Fax:
Mailing address:
  • Phone: 585-355-6606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number059157
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number059157
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: