Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 183442 | NY |
NPI | 1225136443 |
---|---|
Provider Name | Steve Novak |
First Address | Rochester, NY 14642-8409 |
Second Address | Rochester, NY 14642-8409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 27/02/2008 |