Provider Demographics
NPI:1902288442
Name:WOJCIK, MELISSA (MSED)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:WOJCIK
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:CHERNAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3C LAURINDA LN
Mailing Address - Street 2:
Mailing Address - City:BALLSTON LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12019-9049
Mailing Address - Country:US
Mailing Address - Phone:518-258-3885
Mailing Address - Fax:
Practice Address - Street 1:1 RAPP RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-4491
Practice Address - Country:US
Practice Address - Phone:518-867-3061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-21
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196139021174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist