Healthcare Provider Details

I. General information

NPI: 1235055864
Provider Name (Legal Business Name): ASHLEY NOVAK OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 LANCASTER ST
SCHENECTADY NY
12308-1533
US

IV. Provider business mailing address

27A PHEASANT RUN
WATERFORD NY
12188-1000
US

V. Phone/Fax

Practice location:
  • Phone: 518-881-3880
  • Fax:
Mailing address:
  • Phone: 518-728-2602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number031221
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: