Provider Demographics
NPI:1790887875
Name:NOVAK, CLAUDETTE M (RD)
Entity Type:Individual
Prefix:MS
First Name:CLAUDETTE
Middle Name:M
Last Name:NOVAK
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 ELM ST
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-3828
Mailing Address - Country:US
Mailing Address - Phone:978-388-4848
Mailing Address - Fax:978-388-8383
Practice Address - Street 1:238 ELM ST
Practice Address - Street 2:
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-3828
Practice Address - Country:US
Practice Address - Phone:978-388-4848
Practice Address - Fax:978-388-8383
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA849133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA706047OtherTUFTS HEALTH PLAN
MALD0006OtherBLUE CROSS BLUE SHIELD MA
MALD0006OtherBLUE CROSS BLUE SHIELD MA