Provider Demographics
NPI:1871506949
Name:NOVAK, DANIEL B (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:B
Last Name:NOVAK
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4 FARM SPRINGS RD
Mailing Address - Street 2:PROHEALTH PHYSICIANS
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2573
Mailing Address - Country:US
Mailing Address - Phone:860-284-5200
Mailing Address - Fax:860-284-5333
Practice Address - Street 1:400 SAYBROOK RD
Practice Address - Street 2:SUITE 205
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-4773
Practice Address - Country:US
Practice Address - Phone:860-346-7738
Practice Address - Fax:860-347-2097
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CT026510207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTB39408Medicare UPIN