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General NPI Number Information
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NPI Number | 1235134149
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Entity Type | Organization
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Legal Business Name | DAVID P KOWALSKI MD FAMILY PRACTICE PLLC
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 01/08/2013
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Provider Practice Location Address
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Address Line | 3065 SOUTHWESTERN BLVD STE 104
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City | ORCHARD PARK
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State | NY
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Zip | 14127-1239
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Country | US
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Telephone | 716-677-3065
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Fax | 716-677-3065
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Provider Business Mailing Address
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Address Line | 3065 SOUTHWESTERN BLVD STE 104
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City | ORCHARD PARK
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State | NY
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Zip | 14127-1239
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Country | US
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Telephone | 716-677-3065
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Fax | 716-677-3065
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID P KOWALSKI
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Credential | MD
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Telephone | 716-677-3065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 008329
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 204975
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License Number State | NY
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