Provider Demographics
NPI:1245230531
Name:NOWAKOWSKI, FRANCIS SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:SCOTT
Last Name:NOWAKOWSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1176 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6503
Mailing Address - Country:US
Mailing Address - Phone:212-241-8426
Mailing Address - Fax:212-410-1973
Practice Address - Street 1:1176 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6503
Practice Address - Country:US
Practice Address - Phone:212-241-8426
Practice Address - Fax:212-410-1973
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2176852085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8864705Medicaid
NY02134485Medicaid
NY758T71OtherEMPIRE BCBS
NY21768OtherHIP
NY4193528OtherGHI
NY758T71OtherEMPIRE BCBS
NY430T51Medicare ID - Type Unspecified
NJ8864705Medicaid
NYFN0430T510Medicare PIN
NY430T5TG231Medicare PIN