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General NPI Number Information
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NPI Number | 1891757738
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Entity Type | Individual
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Provider Name | WILLIAM A. SOWKA JR.
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Gender | Male
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 12/01/2020
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Provider Practice Location Address
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Address Line | 119 BELMONT ST
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City | WORCESTER
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State | MA
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Zip | 01605-2903
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Country | US
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Telephone | 508-334-6491
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Fax |
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Provider Business Mailing Address
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Address Line | 108 PHELPS RD
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City | WOODSTOCK
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State | CT
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Zip | 06281-2128
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Country | US
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Telephone | 860-974-3094
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 171407
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License Number State | MA
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