Healthcare Provider Details

I. General information

NPI: 1790987832
Provider Name (Legal Business Name): ROBERT MICHAEL WOJTON R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 N AMERICA DR
WEST SENECA NY
14224-5315
US

IV. Provider business mailing address

10395 BERGTOLD RD
CLARENCE NY
14031-2102
US

V. Phone/Fax

Practice location:
  • Phone: 716-677-4805
  • Fax: 716-677-4803
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number040073
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: