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General NPI Number Information
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NPI Number | 1528042108
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Entity Type | Individual
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Provider Name | JUDY ANN WESOLOWSKI MD
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Gender | Female
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 415 TREMONT ST STE 4
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City | NORTH TONAWANDA
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State | NY
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Zip | 14120-6135
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Country | US
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Telephone | 716-656-4077
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 488
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City | BUFFALO
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State | NY
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Zip | 14240-0488
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Country | US
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Telephone | 716-852-4772
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number | 202731
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 202730
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License Number State | NY
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