Provider Demographics
NPI:1295951242
Name:MARTIN L. NOVAK, D.C.
Entity type:Organization
Organization Name:MARTIN L. NOVAK, D.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:NOVAK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-661-5000
Mailing Address - Street 1:527 SHADY AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-4437
Mailing Address - Country:US
Mailing Address - Phone:412-661-5000
Mailing Address - Fax:412-661-4192
Practice Address - Street 1:527 SHADY AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4437
Practice Address - Country:US
Practice Address - Phone:412-661-5000
Practice Address - Fax:412-661-4192
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEWMAN CHIROPRACITC CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-18
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004531L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012766210002Medicaid
PA0012766210002Medicaid
PA647147Medicare ID - Type Unspecified