Provider Demographics
NPI:1881699312
Name:KOWALSKI, DAVID P (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:P
Last Name:KOWALSKI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3065 SOUTHWESTERN BLVD
Mailing Address - Street 2:STE 104
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1239
Mailing Address - Country:US
Mailing Address - Phone:716-677-3065
Mailing Address - Fax:716-712-0497
Practice Address - Street 1:3065 SOUTHWESTERN BLVD
Practice Address - Street 2:STE 104
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1239
Practice Address - Country:US
Practice Address - Phone:716-677-3065
Practice Address - Fax:716-712-0497
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2007-11-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY204975207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00174998OtherRAILROAD MEDICARE
NYG65765Medicare UPIN
NYP00174998OtherRAILROAD MEDICARE