Provider Demographics
NPI:1053405647
Name:NOVATT, AMY MELISSA (MD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:MELISSA
Last Name:NOVATT
Suffix:
Gender:
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6250 ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-3629
Mailing Address - Country:US
Mailing Address - Phone:458-516-4684
Mailing Address - Fax:845-876-2627
Practice Address - Street 1:3712 US-44
Practice Address - Street 2:
Practice Address - City:MILLBROOK
Practice Address - State:NY
Practice Address - Zip Code:12545
Practice Address - Country:US
Practice Address - Phone:845-516-4684
Practice Address - Fax:845-876-2627
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199414207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02251669Medicaid
NYA400116473Medicare PIN
NYA400037334Medicare PIN
NY02251669Medicaid