Healthcare Provider Details

I. General information

NPI: 1033025531
Provider Name (Legal Business Name): ALEXIS VICTORIA NOVAK MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 HANOVER ST
LANCASTER NY
14086-4446
US

IV. Provider business mailing address

26 HANOVER ST
LANCASTER NY
14086-4446
US

V. Phone/Fax

Practice location:
  • Phone: 716-491-8332
  • Fax:
Mailing address:
  • Phone: 716-491-8332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF408714-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: