Provider Demographics
NPI:1417934597
Name:NOVIK, GERALD (MD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:
Last Name:NOVIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PETER RAFFERTY DR
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-1817
Mailing Address - Country:US
Mailing Address - Phone:609-586-9141
Mailing Address - Fax:
Practice Address - Street 1:1235 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:STE. 316 BLDG C
Practice Address - City:MERCERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08619-3810
Practice Address - Country:US
Practice Address - Phone:609-581-5586
Practice Address - Fax:609-581-5779
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA46699173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223709512OtherHORIZON
NJ2261113OtherAETNA HEALTHCARE
NJ1K3955OtherPHS/HEALTHNET
NJ110207563OtherMEDICARE RAILROAD
NJ223709512OtherGREAT WEST
NJMEP126OtherOXFORD HEALTH PLANS
NJ0110663000OtherAMERIHEALTH/KEYSTONE/PERS
NJ0916468OtherCIGNA HEALTHCARE
NJ514460OtherAMERIHEALTH ADMINISTRATOR
NJ105861OtherUNITED HEATLHCARE
NJ4059288OtherTRADITIONAL AETNA
NJMEP126OtherOXFORD HEALTH PLANS
NJ223709512OtherGREAT WEST
NJ514560NVMMedicare ID - Type UnspecifiedMEDICARE