Organization
THOMAS A. KOWALENKO, D.O.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS A KOWALENKO D.O. (OWNER)
(908) 358-8530
Entity
Organization
Contact information
Practice address
808 RARITAN RD, CLARK, NJ 07066-1710
(732) 381-2100
(732) 382-3576
Mailing address
808 RARITAN RD, CLARK, NJ 07066-1710
(732) 381-2100
(732) 382-3576
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MBO6592500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0026808
—
NJ
Enumeration date
08/04/2010
Last updated
08/04/2010
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