1144218181 NPI number — DR. CHRISTOPHER KOWALSKI MD

Table of content: DR. CHRISTOPHER KOWALSKI MD (NPI 1144218181)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144218181 NPI number — DR. CHRISTOPHER KOWALSKI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KOWALSKI
Provider First Name:
CHRISTOPHER
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144218181
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/29/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 OXFORD VALLEY RD STE 701
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YARDLEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19067-7706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-757-5131
Provider Business Mailing Address Fax Number:
215-757-5870

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 OXFORD VALLEY RD STE 701
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YARDLEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19067-7706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-757-5131
Provider Business Practice Location Address Fax Number:
215-757-5870
Provider Enumeration Date:
10/13/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  MD32985 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 25MA07422400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: 04-33691 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: MD420494 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0019587840004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3193882 . This is a "CIGNA PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2185111000 . This is a "KEYSTONE IBC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 30248666 . This is a "KEYSTONE FIRST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1496070 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7488482 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P01515609 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".