Provider Demographics
NPI:1184383044
Name:LINDA KOWALSKI NURSE PRACTITIONER IN FAMILY HEALTH PLLC
Entity type:Organization
Organization Name:LINDA KOWALSKI NURSE PRACTITIONER IN FAMILY HEALTH PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOWALSKI
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:518-843-6860
Mailing Address - Street 1:347 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-2225
Mailing Address - Country:US
Mailing Address - Phone:518-843-6860
Mailing Address - Fax:518-684-0156
Practice Address - Street 1:347 W MAIN ST
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-2225
Practice Address - Country:US
Practice Address - Phone:518-843-6860
Practice Address - Fax:518-684-0156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1861637076Medicaid