Individual
ANGELA M KOWALEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 PORT WATSON ST, CORTLAND, NY 13045-3157
(607) 753-9326
Mailing address
111 PORT WATSON ST, CORTLAND, NY 13045-3157
(607) 753-9326
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
294388-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
294388-1
NYS LPN LICENSE
NY
Enumeration date
01/21/2011
Last updated
01/21/2011
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