Provider Demographics
NPI:1720556681
Name:BIALKOWSKI, EWA
Entity Type:Individual
Prefix:
First Name:EWA
Middle Name:
Last Name:BIALKOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1975 S WHITE RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-1198
Mailing Address - Country:US
Mailing Address - Phone:408-715-6545
Mailing Address - Fax:
Practice Address - Street 1:1975 S WHITE RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-1198
Practice Address - Country:US
Practice Address - Phone:408-715-6545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator