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Individual

MS. LARISSA WOJTENKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1007 MANTUA PIKE STE 2, WEST DEPTFORD, NJ 08096-3963
(856) 853-8004
(856) 856-4654
Mailing address
1007 MANTUA PIKE STE 2, WEST DEPTFORD, NJ 08096-3963
(856) 853-8004
(856) 853-4654

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
25MP00938600
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1750426151
NPI
NJ
Enumeration date
06/23/2025
Last updated
06/23/2025
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