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General NPI Number Information
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NPI Number | 1447626585
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Entity Type | Individual
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Provider Name | ADAM KOWALCZYK
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Gender | Male
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Dates
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Enumeration Date | 08/12/2015
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Last Update Date | 06/26/2016
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Provider Practice Location Address
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Address Line | 476 WILLIAM ST
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City | BUFFALO
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State | NY
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Zip | 14206-1538
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Country | US
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Telephone | 716-847-0424
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Fax |
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Provider Business Mailing Address
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Address Line | 476 WILLIAM ST
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City | BUFFALO
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State | NY
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Zip | 14206-1538
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Country | US
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Telephone | 716-847-0424
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202214327
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 061555
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License Number State | NY
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