Provider Demographics
NPI:1790769917
Name:COWEN, RONALD (DO)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:COWEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 820933
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-0933
Mailing Address - Country:US
Mailing Address - Phone:215-226-8800
Mailing Address - Fax:215-226-8819
Practice Address - Street 1:1300 W LEHIGH AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19132-2701
Practice Address - Country:US
Practice Address - Phone:215-226-8800
Practice Address - Fax:215-226-8819
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA05002312L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA041709OtherHIGHMARK BLUE SHIELD
PA1001463OtherKEYSTONE MERCY HEALTH
PA2Y0377OtherHEALTH NET
PA000588517Medicaid
PA0460696OtherAETNA HMO
PA544675OtherCOVENTRY HEALTH AMERICA
PA5528438OtherAETNA PPO
PA698OtherBRAVO HEALTH
PACD4829OtherRAILROAD MEDICARE TPI GROUP
PAPHP081OtherOXFORD
PA0057925000OtherINDEPENDENCE BLUE CROSS
PA080114274OtherRAILROAD MEDICARE
PA597586OtherMEDICARE GROUP TPI
PA544675OtherCOVENTRY HEALTH AMERICA
PA2Y0377OtherHEALTH NET