Provider Demographics
NPI:1750380473
Name:CHRISTOPHER J. NOWIK, O.D., P.C.
Entity type:Organization
Organization Name:CHRISTOPHER J. NOWIK, O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:NOWIK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:610-588-0129
Mailing Address - Street 1:385 BANGOR JUNCTION RD
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:PA
Mailing Address - Zip Code:18013-9369
Mailing Address - Country:US
Mailing Address - Phone:610-588-0129
Mailing Address - Fax:610-588-4700
Practice Address - Street 1:385 BANGOR JUNCTION RD
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:PA
Practice Address - Zip Code:18013-9369
Practice Address - Country:US
Practice Address - Phone:610-588-0129
Practice Address - Fax:610-588-4700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000536152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5029340001OtherDMERC A
PANO1593770OtherHIGHMARK BLUE SHIELD
PADB2982OtherRAILROAD MEDICARE
PA02427500OtherCAPITAL BLUE CROSS
PA4508644OtherAETNA
PA4508644OtherAETNA
PANO1593770OtherHIGHMARK BLUE SHIELD