Provider Demographics
NPI:1689948747
Name:BOWEN, PIA KATHLEEN (NP)
Entity Type:Individual
Prefix:
First Name:PIA
Middle Name:KATHLEEN
Last Name:BOWEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 E 89TH ST
Mailing Address - Street 2:APT 3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3462
Mailing Address - Country:US
Mailing Address - Phone:917-775-1973
Mailing Address - Fax:
Practice Address - Street 1:636 E 89TH ST
Practice Address - Street 2:APT 3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3462
Practice Address - Country:US
Practice Address - Phone:917-775-1973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-06
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY619189-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No163W00000XNursing Service ProvidersRegistered Nurse