Healthcare Provider Details

I. General information

NPI: 1861219974
Provider Name (Legal Business Name): EMMA KOWIAK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2024
Last Update Date: 09/21/2024
Certification Date: 09/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 1ST AVE
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

100 MAIDEN LN APT 606
NEW YORK NY
10038-4874
US

V. Phone/Fax

Practice location:
  • Phone: 646-929-7870
  • Fax:
Mailing address:
  • Phone: 813-850-7018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberF433000-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: