MEDICARE: DR. SARAH NOVOTNY DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	013376	NY

General Provider Information

NPI Number	:	1396362844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH NOVOTNY DC

Provider Business Mailing Address
First Line	:	84 SWEENEY ST
Second Line	:
City	:	NORTH TONAWANDA
State	:	NY
Zip	:	14120-5822
Country	:	US
Telephone Number	:	716-640-5565
Fax Number	:

Provider Business Practice Location Address
First Line	:	84 SWEENEY ST
Second Line	:
City	:	NORTH TONAWANDA
State	:	NY
Zip	:	14120-5822
Country	:	US
Telephone Number	:	716-640-5565
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2020
Last Update Date	:	07/01/2020

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