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NPI Code Detail

MEDICARE: SHELLEY JAKEMAN WOJTASZCZYK FNP-C

MEDICARE: SHELLEY JAKEMAN WOJTASZCZYK FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerF331617-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326034752
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLEY JAKEMAN WOJTASZCZYK FNP-C
Provider Business Mailing Address
First Line : 7311 NORTHWOODS RD
Second Line :
City : ARCADE
State : NY
Zip : 14009-9530
Country : US
Telephone Number : 585-496-2075
Fax Number :
Provider Business Practice Location Address
First Line : 3435 BAILEY AVE
Second Line :
City : BUFFALO
State : NY
Zip : 14215-1145
Country : US
Telephone Number : 716-835-2966
Fax Number : 716-834-3901
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2005
Last Update Date : 05/12/2008

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