Healthcare Provider Details

I. General information

NPI: 1154805273
Provider Name (Legal Business Name): MAGDALENA JULIA KOWALIK AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2018
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2073 KLOCKNER RD
HAMILTON NJ
08690-3414
US

IV. Provider business mailing address

2073 KLOCKNER RD
HAMILTON NJ
08690-3414
US

V. Phone/Fax

Practice location:
  • Phone: 609-584-1212
  • Fax: 609-584-0103
Mailing address:
  • Phone: 609-584-1212
  • Fax: 609-584-0103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number26NJ00928800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberSP018406
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: