Healthcare Provider Details

I. General information

NPI: 1326499963
Provider Name (Legal Business Name): ROSALIN KOWALCZEWSKI R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2016
Last Update Date: 06/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3409 GENESEE ST
CHEEKTOWAGA NY
14225-5051
US

IV. Provider business mailing address

168 LYNDALE CT
WEST SENECA NY
14224-1967
US

V. Phone/Fax

Practice location:
  • Phone: 716-855-7723
  • Fax: 716-855-3920
Mailing address:
  • Phone: 716-855-7723
  • Fax: 716-855-3920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number554838
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: