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Individual

THOMAS M KOWALAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3669 SOUTHWESTERN BLVD, ORCHARD PARK, NY 14127-1732
(716) 688-2154
(716) 204-4501
Mailing address
2530 E RIVER RD, GRAND ISLAND, NY 14072-2193
(716) 775-9247
(716) 775-9247

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
180089
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01222559
NY
Enumeration date
05/22/2006
Last updated
09/27/2012
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