Basic Information
| Provider Information | |||||||||
| NPI: | 1386761039 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KOVALSZKI | ||||||||
| FirstName: | KATALIN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 526 MAIN ST | ||||||||
| Address2: | SUITE 302 | ||||||||
| City: | ACTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 017203301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9783717010 | ||||||||
| FaxNumber: | 9783710522 | ||||||||
| Practice Location | |||||||||
| Address1: | 133 LITTLETON RD | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | WESTFORD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018863115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9786929978 | ||||||||
| FaxNumber: | 9783710522 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2007 | ||||||||
| LastUpdateDate: | 10/27/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 239821 | MA | Y | Allopathic & Osteopathic Physicians | Dermatology |
No ID Information.