Provider Demographics
NPI:1194732453
Name:KALOWSKY, JOSEPH DANIEL (DO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:DANIEL
Last Name:KALOWSKY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:SUGARLOAF
Mailing Address - State:PA
Mailing Address - Zip Code:18249-9777
Mailing Address - Country:US
Mailing Address - Phone:570-788-3502
Mailing Address - Fax:570-819-5139
Practice Address - Street 1:1111 E END BLVD
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18711-0030
Practice Address - Country:US
Practice Address - Phone:570-824-3521
Practice Address - Fax:570-819-5139
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002468L2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB40164Medicare UPIN