Provider Demographics
NPI:1588148753
Name:CHOJECKI, D. THEODORE
Entity type:Individual
Prefix:
First Name:D. THEODORE
Middle Name:
Last Name:CHOJECKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 BROCKTON DR
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-9273
Mailing Address - Country:US
Mailing Address - Phone:716-201-1049
Mailing Address - Fax:
Practice Address - Street 1:6000 BROCKTON DR
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-9273
Practice Address - Country:US
Practice Address - Phone:716-201-1049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043207225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist