Active NPI
Christopher Michael Kotowski, PHARMD
- Pharmacist
- Lackawanna, NY
National Provider Identifier
1902089139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 051938
- Practice address
- 1328 Abbott Rd
Lackawanna, NY 14218-1910 - Phone
- (716) 828-1696
- Fax
- (716) 828-1089
- NPI assigned
- Dec 11, 2007
- Last updated
- Sep 21, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051938 | NY | Primary |
Addresses
Primary practice location
1328 Abbott Rd
Lackawanna, NY 14218-1910
Mailing address
1328 Abbott Rd
Lackawanna, NY 14218-1910
Phone (716) 828-1696
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01912716 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051938 | NY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Eastern Co Inc | Past | Accepting new patients | |
| Walgreen Eastern Co Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1197331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316563200000",
"number": "1902089139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1328 ABBOTT RD",
"city": "LACKAWANNA",
"state": "NY",
"postal_code": "142181910",
"telephone_number": "716-828-1696",
"fax_number": "716-828-1089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1328 ABBOTT RD",
"city": "LACKAWANNA",
"state": "NY",
"postal_code": "142181910",
"telephone_number": "716-828-1696",
"fax_number": "716-828-1089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOTOWSKI",
"first_name": "CHRISTOPHER",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-11",
"last_updated": "2011-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "051938",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01912716",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lackawanna, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.