MEDICARE: DR. HARVEY JAY KOWALOFF M.D.

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	207R00000X	Internal Medicine Physician	45979	MA

General Provider Information

NPI Number	:	1700863016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARVEY JAY KOWALOFF M.D.

Provider Business Mailing Address
First Line	:	275 SANDWICH ST
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-2183
Country	:	US
Telephone Number	:	508-830-2198
Fax Number	:

Provider Business Practice Location Address
First Line	:	275 SANDWICH ST
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-2183
Country	:	US
Telephone Number	:	508-830-2198
Fax Number	:

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

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	08/17/2022

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