Provider Demographics
NPI:1437209145
Name:KOWALSKI, MATTHEW H (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:H
Last Name:KOWALSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 BOYLSTON ST, SUITE 422
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467
Mailing Address - Country:US
Mailing Address - Phone:617-732-9417
Mailing Address - Fax:617-732-9480
Practice Address - Street 1:850 BOYLSTON ST SUITE 422
Practice Address - Street 2:BRIGHAM AND WOMEN'S HOSPITAL
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467
Practice Address - Country:US
Practice Address - Phone:617-732-9700
Practice Address - Fax:617-732-9480
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1681111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA4400420OtherUNITED HEALTHCARE
MA351213OtherHARVARD
MAY36208OtherBLUE CROSS
MA168100OtherTUFTS
MA6913875OtherCIGNA
MA2872848OtherAETNA
MAY36208Medicare ID - Type Unspecified
MA351213OtherHARVARD