Healthcare Provider Details
I. General information
NPI: 1205753670
Provider Name (Legal Business Name): NOVA MEDICO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
901 PAGE RD
OLEAN NY
14760-9671
US
IV. Provider business mailing address
901 PAGE RD
OLEAN NY
14760-9671
US
V. Phone/Fax
- Phone: 585-403-1852
- Fax:
- Phone: 585-403-1852
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALAN
HAIGHT
Title or Position: CEO
Credential: MD
Phone: 585-403-1852