Provider Demographics
NPI:1114934585
Name:NOVICH, ROBERT KALMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:KALMAN
Last Name:NOVICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2001 PALMER AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-2468
Mailing Address - Country:US
Mailing Address - Phone:914-633-8705
Mailing Address - Fax:914-633-5609
Practice Address - Street 1:2001 PALMER AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-2468
Practice Address - Country:US
Practice Address - Phone:914-633-8705
Practice Address - Fax:914-633-5609
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY124336207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03A711Medicare PIN