Provider Demographics
NPI:1609898964
Name:NOVAK, JOHN S (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:NOVAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:121 LEGION DR
Mailing Address - Street 2:
Mailing Address - City:COBLESKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12043-5111
Mailing Address - Country:US
Mailing Address - Phone:518-234-2555
Mailing Address - Fax:518-234-8449
Practice Address - Street 1:121 LEGION DR
Practice Address - Street 2:
Practice Address - City:COBLESKILL
Practice Address - State:NY
Practice Address - Zip Code:12043-5111
Practice Address - Country:US
Practice Address - Phone:518-234-2555
Practice Address - Fax:518-234-8449
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY239175207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics