MEDICARE: PAUL ANTONI KOWACKI DC

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
1	111N00000X	Chiropractor	928	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	727902	OTHER	TUFTS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2993701	OTHER	AETNA
4	18961	OTHER	CIGNA
5	350264	OTHER	HARVARD PILGRIM
6	612073	OTHER	ACN GROUP
7	46234	OTHER	FALLON
8	4403000	OTHER	UNITED HEALTH PLANS OF NE

General Provider Information

NPI Number	:	1629136981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL ANTONI KOWACKI DC

Provider Business Mailing Address
First Line	:	28 NORTH MAIN ST
Second Line	:	PO BOX 118
City	:	ORANGE
State	:	MA
Zip	:	01364-0118
Country	:	US
Telephone Number	:	978-544-7902
Fax Number	:	978-544-7902

Provider Business Practice Location Address
First Line	:	28 NORTH MAIN ST
Second Line	:
City	:	ORANGE
State	:	MA
Zip	:	01364-0118
Country	:	US
Telephone Number	:	978-544-7902
Fax Number	:	978-544-7902

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	07/08/2007

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Directions to “ PAUL ANTONI KOWACKI DC” Practice Location

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