MEDICARE: MR. STEPHEN DANIEL KOWALSKI DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT023028	PA

General Provider Information

NPI Number	:	1265863690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN DANIEL KOWALSKI DPT

Provider Business Mailing Address
First Line	:	709 DUNCAN AVE APT 506
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15237-5021
Country	:	US
Telephone Number	:	732-773-6899
Fax Number	:

Provider Business Practice Location Address
First Line	:	4960 ROUTE 8
Second Line	:
City	:	ALLISON PARK
State	:	PA
Zip	:	15101-2354
Country	:	US
Telephone Number	:	724-443-8060
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2013
Last Update Date	:	12/11/2013

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