Individual
DR. THOMAS A KOWALENKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
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
25MB06592500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0026808
—
NJ
Enumeration date
03/01/2006
Last updated
07/27/2010
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