Healthcare Provider Details

I. General information

NPI: 1932512357
Provider Name (Legal Business Name): ALEXANDER KOWALSKI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2014
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 FRIES MILL RD STE N3
TURNERSVILLE NJ
08012-2055
US

IV. Provider business mailing address

188 FRIES MILL RD STE N3
TURNERSVILLE NJ
08012-2055
US

V. Phone/Fax

Practice location:
  • Phone: 844-542-2273
  • Fax: 856-875-8494
Mailing address:
  • Phone: 844-542-2273
  • Fax: 856-875-8494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB09943800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: