Provider Demographics
NPI:1396362844
Name:NOVOTNY, SARAH (DC)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:NOVOTNY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 SWEENEY ST
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-5822
Mailing Address - Country:US
Mailing Address - Phone:716-640-5565
Mailing Address - Fax:
Practice Address - Street 1:84 SWEENEY ST
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-5822
Practice Address - Country:US
Practice Address - Phone:716-640-5565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013376111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor