Provider Demographics
NPI:1619117538
Name:COWIE, ALBERT R (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:R
Last Name:COWIE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:100 COLLEGE PKWY
Mailing Address - Street 2:SUITE 180
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-6800
Mailing Address - Country:US
Mailing Address - Phone:716-636-1902
Mailing Address - Fax:716-636-1367
Practice Address - Street 1:100 COLLEGE PKWY
Practice Address - Street 2:SUITE 180
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-6800
Practice Address - Country:US
Practice Address - Phone:716-636-1902
Practice Address - Fax:716-636-1367
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2428812085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03220188Medicaid
NYJ400020236Medicare PIN