Healthcare Provider Details

I. General information

NPI: 1730270992
Provider Name (Legal Business Name): MICHAL HOVAK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 04/01/2022
Certification Date: 02/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OXFORD XING STE 3
NEW HARTFORD NY
13413-3200
US

IV. Provider business mailing address

1 OXFORD XING STE 3
NEW HARTFORD NY
13413-3200
US

V. Phone/Fax

Practice location:
  • Phone: 315-662-0162
  • Fax: 315-662-0107
Mailing address:
  • Phone: 315-662-0162
  • Fax: 315-662-0107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number334882
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: