| Thomas A. Kowalenko, D.O. | |
|
808 Raritan Rd Clark NJ 07066-1710 | |
| (732) 381-2100 | |
| (732) 382-3576 |
| Full Name | Thomas A. Kowalenko, D.O. |
|---|---|
| Speciality | Family Medicine |
| Location | 808 Raritan Rd, Clark, New Jersey |
| Authorized Official Name and Position | Thomas a Kowalenko (OWNER) |
| Authorized Official Contact | 9083588530 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas A. Kowalenko, D.O. 808 Raritan Rd Clark NJ 07066-1710 Ph: (732) 381-2100 | Thomas A. Kowalenko, D.O. 808 Raritan Rd Clark NJ 07066-1710 Ph: (732) 381-2100 |
| NPI Number | 1407160245 |
|---|---|
| Provider Enumeration Date | 08/04/2010 |
| Last Update Date | 08/04/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407160245 | NPI | - | NPPES |
| 0026808 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 25MBO6592500 (New Jersey) | Primary |
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