Provider Demographics
NPI:1376420984
Name:COWAN, ALBERTA NATTELL (CRT)
Entity type:Individual
Prefix:
First Name:ALBERTA
Middle Name:NATTELL
Last Name:COWAN
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 PARK AVE APT
Mailing Address - Street 2:APT.6H
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550
Mailing Address - Country:US
Mailing Address - Phone:347-266-8944
Mailing Address - Fax:
Practice Address - Street 1:THE ENCLAVE REHAB 1000 HIGH STREET
Practice Address - Street 2:
Practice Address - City:PORTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10573
Practice Address - Country:US
Practice Address - Phone:410-271-2825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001101227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified