Provider Demographics
NPI:1396837423
Name:NOVAK, DEBRA I (DC)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:I
Last Name:NOVAK
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 1:3806 WEALTH ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-1739
Mailing Address - Country:US
Mailing Address - Phone:412-734-9157
Mailing Address - Fax:
Practice Address - Street 1:3445 BABCOCK BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2443
Practice Address - Country:US
Practice Address - Phone:412-719-4155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002758L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U18999Medicare ID - Type Unspecified