Provider Demographics
NPI:1598970055
Name:NOVIASKY, JOHN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:NOVIASKY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7949 STEUBEN STREET
Mailing Address - Street 2:
Mailing Address - City:HOLLAND PATENT
Mailing Address - State:NY
Mailing Address - Zip Code:13354
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7949 STEUBEN STREET
Practice Address - Street 2:
Practice Address - City:HOLLAND PATENT
Practice Address - State:NY
Practice Address - Zip Code:13354
Practice Address - Country:US
Practice Address - Phone:315-798-8314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037193183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist