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General NPI Number Information
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NPI Number | 1891720322
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Entity Type | Organization
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Legal Business Name | MARTIN COWAN MDPC
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 23 HIGH ST
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City | MONTICELLO
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State | NY
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Zip | 12701-1331
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Country | US
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Telephone | 845-794-5558
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Fax | 845-794-0135
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Provider Business Mailing Address
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Address Line | 23 HIGH ST
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City | MONTICELLO
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State | NY
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Zip | 12701-1331
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Country | US
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Telephone | 845-794-5558
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Fax | 845-794-0135
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Authorized Official
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Title or Position | MD/PRESIDENT
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Name | DR. MARTIN COWAN
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Credential | MD
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Telephone | 845-794-5558
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 090532
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License Number State | NY
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