Healthcare Provider Details

I. General information

NPI: 1134791031
Provider Name (Legal Business Name): JARED MARKUS WOJCIKIEWICZ PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2021
Last Update Date: 07/12/2021
Certification Date: 07/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL AVE
DU BOIS PA
15801-1440
US

IV. Provider business mailing address

551 SANDY HILL RD
VALENCIA PA
16059-2727
US

V. Phone/Fax

Practice location:
  • Phone: 724-591-2495
  • Fax:
Mailing address:
  • Phone: 724-591-2495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: