Provider / Organization | NPI | Date Certified |
---|---|---|
MARISSA NOVACK | 1235525650 | 2022-05-20 |
Marissa Novack is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1235525650. Registration indicates Marissa Novack is a provider of services with a specialization in Allopathic & Osteopathic Physicians, Surgery (Surgery, ) (Specialist Network, ) (Surgery, Allopathic & Osteopathic Physicians) (Student, Health Care, Student in an Organized Health Care Education/Training Program) (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) (Allopathic & Osteopathic Physicians, Surgery) (Surgery, ) (Specialist Network, ) (Surgery, Allopathic & Osteopathic Physicians)
Entity Type | Individual |
Provider Name | Dr. Marissa Novack MD |
Practice Office Address | 100 HIGH ST BUFFALO, NY US |
Practice Office Telephone | 5702059143 |
Mailing Address | 100 HIGH ST STE D3 BUFFALO, NY 142031126 US |
Code | Practice | License No State |
---|---|---|
208600000X | Allopathic & Osteopathic Physicians Surgery Surgery Specialist Network Surgery Allopathic & Osteopathic Physicians | 48150426
NY |
390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
208600000X PRIMARY | Allopathic & Osteopathic Physicians Surgery Surgery Specialist Network Surgery Allopathic & Osteopathic Physicians | 308402
NY |
193400000X SING | Group Code |