Healthcare Provider Details

I. General information

NPI: 1437385697
Provider Name (Legal Business Name): ESTHER KOWALSKY P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2009
Last Update Date: 06/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 CRESTHILL AVE
CLIFTON NJ
07012-1835
US

IV. Provider business mailing address

63 CRESTHILL AVE
CLIFTON NJ
07012-1835
US

V. Phone/Fax

Practice location:
  • Phone: 973-773-0999
  • Fax:
Mailing address:
  • Phone: 973-773-0999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number026437-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01274600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: