Provider Demographics
NPI:1326499963
Name:KOWALCZEWSKI, ROSALIN (RN)
Entity Type:Individual
Prefix:
First Name:ROSALIN
Middle Name:
Last Name:KOWALCZEWSKI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 LYNDALE CT
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-1967
Mailing Address - Country:US
Mailing Address - Phone:716-855-7723
Mailing Address - Fax:716-855-3920
Practice Address - Street 1:3409 GENESEE ST
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-5051
Practice Address - Country:US
Practice Address - Phone:716-855-7723
Practice Address - Fax:716-855-3920
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY554838163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse