Healthcare Provider Details

I. General information

NPI: 1649325465
Provider Name (Legal Business Name): MEREDITH KOWALSKY M.S., P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9082 BOCA GARDENS PKWY APT B
BOCA RATON FL
33496-4214
US

IV. Provider business mailing address

9082 BOCA GARDENS PKWY APT A
BOCA RATON FL
33496-4214
US

V. Phone/Fax

Practice location:
  • Phone: 917-922-8990
  • Fax:
Mailing address:
  • Phone: 917-922-8990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number007968
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT41088
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: