Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0205X | Pediatric Endocrinologist | 293706 | NY |
Y | 2080P0205X | Pediatric Endocrinologist | MD475026 | PA |
NPI | 1356720650 |
---|---|
Provider Name | Dr. Shira Novack |
First Address | Lemoyne, PA 17043-1168 |
Second Address | Lemoyne, PA 17043-1168 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2015 |
Last Update Date | 13/10/2021 |