Provider Demographics
NPI:1518634195
Name:NOVY, DANIEL R
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:R
Last Name:NOVY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 362
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-0362
Mailing Address - Country:US
Mailing Address - Phone:323-821-2709
Mailing Address - Fax:
Practice Address - Street 1:1760 MUIRFIELD LN
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-4821
Practice Address - Country:US
Practice Address - Phone:323-821-2709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide