Healthcare Provider Details

I. General information

NPI: 1720970056
Provider Name (Legal Business Name): MALIKA NOVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

373 AVENUE S APT 1B
BROOKLYN NY
11223-2922
US

IV. Provider business mailing address

373 AVENUE S APT 1B
BROOKLYN NY
11223-2922
US

V. Phone/Fax

Practice location:
  • Phone: 347-707-6454
  • Fax:
Mailing address:
  • Phone: 347-707-6454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number798483
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: