Healthcare Provider Details

I. General information

NPI: 1982120481
Provider Name (Legal Business Name): KOWALSKI SURGICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2017
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 TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD420494
License Number State

VIII. Authorized Official

Name: CHRISTOPHER KOWALSKI
Title or Position: OWNER
Credential: MD
Phone: 215-757-5131