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General NPI Number Information
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NPI Number | 1659353753
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Entity Type | Individual
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Provider Name | TERRANCE J KWIATKOWSKI MD
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Gender | Male
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 03/15/2025
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Provider Practice Location Address
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Address Line | 10410 S EASTERN AVE STE 110
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City | HENDERSON
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State | NV
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Zip | 89052-4196
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Country | US
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Telephone | 702-966-3100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 530521
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City | HENDERSON
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State | NV
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Zip | 89053-0521
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Country | US
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Telephone | 702-966-3100
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Fax | 702-966-9909
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 9962
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207YX0901X
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Taxonomy Name | Otology & Neurotology Physician
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License Number | 9962
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License Number State | NV
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