Healthcare Provider Details

I. General information

NPI: 1932174802
Provider Name (Legal Business Name): ALLISON S COWL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 09/09/2022
Certification Date: 09/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 WASHINGTON ST
HARTFORD CT
06106-3322
US

IV. Provider business mailing address

79 DUGWAY RD
PETERSHAM MA
01366-9725
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-8737
  • Fax: 860-545-9800
Mailing address:
  • Phone: 978-724-0214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number220608
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number220608
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: