Provider Demographics
NPI:1518141803
Name:JUDITH A. NOWAK, M.D., P.C.
Entity Type:Organization
Organization Name:JUDITH A. NOWAK, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:NOWAK
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:202-887-5495
Mailing Address - Street 1:908 NEW HAMPSHIRE AVE, N.W.
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WASHINGTON,
Mailing Address - State:DC
Mailing Address - Zip Code:20037-2349
Mailing Address - Country:US
Mailing Address - Phone:202-887-5495
Mailing Address - Fax:202-466-5582
Practice Address - Street 1:908 NEW HAMPSHIRE AVE, N.W.
Practice Address - Street 2:SUITE 302
Practice Address - City:WASHINGTON,
Practice Address - State:DC
Practice Address - Zip Code:20037-2349
Practice Address - Country:US
Practice Address - Phone:202-887-5495
Practice Address - Fax:202-466-5582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD118672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty