Provider Demographics
NPI:1215480751
Name:WROBLEWSKI, MAUREEN ANN (PNP-BC)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:ANN
Last Name:WROBLEWSKI
Suffix:
Gender:F
Credentials:PNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 S PERRY ST
Mailing Address - Street 2:JOHNSTOWN PEDIATRIC HEALTH CENTER
Mailing Address - City:JOHNSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12095-3213
Mailing Address - Country:US
Mailing Address - Phone:518-762-3161
Mailing Address - Fax:518-762-4902
Practice Address - Street 1:700 S PERRY ST
Practice Address - Street 2:JOHNSTOWN PEDIATRIC HEALTH CENTER
Practice Address - City:JOHNSTOWN
Practice Address - State:NY
Practice Address - Zip Code:12095-3213
Practice Address - Country:US
Practice Address - Phone:518-762-3161
Practice Address - Fax:518-762-4902
Is Sole Proprietor?:No
Enumeration Date:2016-08-02
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY382666363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics