Healthcare Provider Details

I. General information

NPI: 1144218181
Provider Name (Legal Business Name): CHRISTOPHER KOWALSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 OXFORD VALLEY RD STE 701
YARDLEY PA
19067-7706
US

IV. Provider business mailing address

301 OXFORD VALLEY RD STE 701
YARDLEY PA
19067-7706
US

V. Phone/Fax

Practice location:
  • Phone: 215-757-5131
  • Fax: 215-757-5870
Mailing address:
  • Phone: 215-757-5131
  • Fax: 215-757-5870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD32985
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number25MA07422400
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number04-33691
License Number StateKS
# 4
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD420494
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: