Provider Demographics
NPI:1417023185
Name:NOVIE-HERMAN, MICHELLE ROBYN (RN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ROBYN
Last Name:NOVIE-HERMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 13TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4802
Mailing Address - Country:US
Mailing Address - Phone:718-222-6600
Mailing Address - Fax:
Practice Address - Street 1:50 JAY ST
Practice Address - Street 2:MEDICAL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-1144
Practice Address - Country:US
Practice Address - Phone:718-222-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY371308-0163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator