Provider Demographics
NPI:1497727390
Name:KOWALSKI, WILLIAM J (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:KOWALSKI
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 1:3920 US ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-4047
Mailing Address - Country:US
Mailing Address - Phone:518-822-0060
Mailing Address - Fax:518-822-0061
Practice Address - Street 1:3920 US ROUTE 9
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-4047
Practice Address - Country:US
Practice Address - Phone:518-822-0060
Practice Address - Fax:518-822-0061
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-03
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3925-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYT52581Medicare UPIN
NYX21231Medicare ID - Type UnspecifiedMEDICARE #