Healthcare Provider Details

I. General information

NPI: 1154050532
Provider Name (Legal Business Name): ALEKSANDER KOWARZ DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2022
Last Update Date: 06/09/2022
Certification Date: 06/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 EAGLE ROCK AVE
EAST HANOVER NJ
07936-3167
US

IV. Provider business mailing address

11 EAGLE ROCK AVE
EAST HANOVER NJ
07936-3167
US

V. Phone/Fax

Practice location:
  • Phone: 973-887-9000
  • Fax: 973-887-3816
Mailing address:
  • Phone: 973-887-9000
  • Fax: 973-887-3816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA02091000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: