Provider Demographics
NPI:1114086493
Name:KOWAL, RICHARD (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:KOWAL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 W 73RD ST
Mailing Address - Street 2:SUITE GD
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-3104
Mailing Address - Country:US
Mailing Address - Phone:212-799-2520
Mailing Address - Fax:
Practice Address - Street 1:23 W 73RD ST
Practice Address - Street 2:SUITE GD
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-3104
Practice Address - Country:US
Practice Address - Phone:212-799-2520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX3482111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX20901Medicare ID - Type Unspecified