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General NPI Number Information
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NPI Number | 1558760124
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Entity Type | Individual
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Provider Name | SRIVATSA CHIHNA KOWSIKA PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/19/2014
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 4755 OGLETOWN STANTON RD STE 5A43
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City | NEWARK
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State | DE
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Zip | 19718-2200
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Country | US
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Telephone | 302-623-0188
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Fax | 302-733-5640
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Provider Business Mailing Address
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Address Line | 15059 N SCOTTSDALE RD STE 600
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-2685
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Country | US
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Telephone | 602-778-3601
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Fax | 928-432-7001
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601007070
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0009591
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C5-0001060
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License Number State | DE
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