Healthcare Provider Details

I. General information

NPI: 1811970163
Provider Name (Legal Business Name): ZUZANA EVA NOVAK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2005
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4705 MONTGOMERY BLVD NE
ALBUQUERQUE NM
87109-1226
US

IV. Provider business mailing address

PO BOX 2289
HUNTSVILLE AL
35804-2289
US

V. Phone/Fax

Practice location:
  • Phone: 855-222-9637
  • Fax:
Mailing address:
  • Phone: 256-536-9587
  • Fax: 256-536-9588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number20985
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD2016-0057
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: