Healthcare Provider Details

I. General information

NPI: 1053405647
Provider Name (Legal Business Name): AMY MELISSA NOVATT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 05/06/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3712 US-44
MILLBROOK NY
12545
US

IV. Provider business mailing address

6250 ROUTE 9
RHINEBECK NY
12572-3629
US

V. Phone/Fax

Practice location:
  • Phone: 845-516-4684
  • Fax: 845-876-2627
Mailing address:
  • Phone: 458-516-4684
  • Fax: 845-876-2627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number199414
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: