MEDICARE: DIANE PAULINE KOWALSKI MD

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	207ZC0500X	Cytopathology Physician	038380	CT
2	207ZP0101X	Anatomic Pathology Physician	038380	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881675197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE PAULINE KOWALSKI MD

Provider Business Mailing Address
First Line	:	300 GEORGE ST
Second Line	:	6TH FLOOR PO BOX 9805
City	:	NEW HAVEN
State	:	CT
Zip	:	06536-0805
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 YORK ST
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06504-8900
Country	:	US
Telephone Number	:	203-785-6933
Fax Number	:

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

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	08/04/2008

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