Provider Demographics
NPI:1518949254
Name:NOVELLA, STEVEN P (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:P
Last Name:NOVELLA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:40 TEMPLE ST
Mailing Address - Street 2:SUITE 6-C
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-2715
Mailing Address - Country:US
Mailing Address - Phone:203-785-4085
Mailing Address - Fax:203-737-1597
Practice Address - Street 1:40 TEMPLE ST
Practice Address - Street 2:SUITE 6-C
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-2715
Practice Address - Country:US
Practice Address - Phone:203-785-4085
Practice Address - Fax:203-737-1597
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2011-03-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT0333322084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001333327Medicaid
G12939Medicare UPIN
CT130000440Medicare ID - Type Unspecified