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General NPI Number Information
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NPI Number | 1093916389
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Entity Type | Individual
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Provider Name | MARILYN NOVICH M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | PRIVATE HEALTH CARE SYSTEMS 1100 WINTER STREET
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City | WALTHAM
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State | MA
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Zip | 02451-0921
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Country | US
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Telephone | 781-895-7500
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Fax |
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Provider Business Mailing Address
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Address Line | 19 STETSON ST
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City | BROOKLINE
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State | MA
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Zip | 02446-7106
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Country | US
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Telephone | 781-895-7500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 47343
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License Number State | MA
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