Healthcare Provider Details

I. General information

NPI: 1558586859
Provider Name (Legal Business Name): KATHERINE KOWALSKI N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST OCCUPATIONAL HEALTH DEPARTMENT
NEW YORK NY
10021-4870
US

IV. Provider business mailing address

135 MADISON RD
SCARSDALE NY
10583-6219
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-4370
  • Fax:
Mailing address:
  • Phone: 914-713-8561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number301128
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: