Provider Demographics
NPI:1609158021
Name:KOWALSKI, DANIEL STANLEY (RPH)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:STANLEY
Last Name:KOWALSKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 NEW GRANVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-1107
Mailing Address - Country:US
Mailing Address - Phone:302-234-3376
Mailing Address - Fax:
Practice Address - Street 1:103 NEW GRANVILLE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-1107
Practice Address - Country:US
Practice Address - Phone:302-234-3376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0001745183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist