Provider Demographics
NPI:1568568228
Name:DENNIS NOVAK, MD PA
Entity Type:Organization
Organization Name:DENNIS NOVAK, MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:NOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:DD
Authorized Official - Phone:609-693-8900
Mailing Address - Street 1:1001 LACEY RD
Mailing Address - Street 2:
Mailing Address - City:FORKED RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08731-1042
Mailing Address - Country:US
Mailing Address - Phone:609-693-8900
Mailing Address - Fax:609-971-2888
Practice Address - Street 1:1001 LACEY RD
Practice Address - Street 2:
Practice Address - City:FORKED RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08731-1042
Practice Address - Country:US
Practice Address - Phone:609-693-8900
Practice Address - Fax:609-971-2888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty