Provider Demographics
NPI:1215379946
Name:NOVOGRODER, HAVIVA (MS SP ED)
Entity Type:Individual
Prefix:
First Name:HAVIVA
Middle Name:
Last Name:NOVOGRODER
Suffix:
Gender:F
Credentials:MS SP ED
Other - Prefix:
Other - First Name:HAVIVA
Other - Middle Name:
Other - Last Name:KRAMER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:530 GRAND ST
Mailing Address - Street 2:F1E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-4258
Mailing Address - Country:US
Mailing Address - Phone:718-522-2122
Mailing Address - Fax:718-522-6983
Practice Address - Street 1:57 WILLOUGHBY ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5257
Practice Address - Country:US
Practice Address - Phone:718-522-2122
Practice Address - Fax:718-522-6983
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY665553961174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist