Provider Demographics
NPI:1659516052
Name:NOVECK, MARLENE R (SLP)
Entity Type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:R
Last Name:NOVECK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W END AVE APT 12F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5732
Mailing Address - Country:US
Mailing Address - Phone:212-769-4926
Mailing Address - Fax:
Practice Address - Street 1:150 W END AVE APT 12F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-5732
Practice Address - Country:US
Practice Address - Phone:212-769-4926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-14
Last Update Date:2008-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012398-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist