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General NPI Number Information
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NPI Number | 1457400517
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Entity Type | Individual
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Provider Name | RONALD S KOWALIK OD
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Gender | Male
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 57 BELMONT AVE
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City | GARFIELD
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State | NJ
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Zip | 07026-3203
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Country | US
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Telephone | 973-340-0489
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Fax |
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Provider Business Mailing Address
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Address Line | 57 BELMONT AVE
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City | GARFIELD
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State | NJ
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Zip | 07026-3203
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Country | US
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Telephone | 973-340-0489
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00299001
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | K0521338
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1608002
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | UPN U26870
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License Number State | NJ
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