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General NPI Number Information
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NPI Number | 1194785550
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Entity Type | Individual
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Provider Name | RICHARD NOVITCH M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 03/14/2022
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Provider Practice Location Address
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Address Line | 199 MOUNT EDEN PKWY
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City | BRONX
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State | NY
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Zip | 10457-7703
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Country | US
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Telephone | 718-992-7669
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Fax |
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Provider Business Mailing Address
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Address Line | 1276 FULTON AVE
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City | BRONX
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State | NY
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Zip | 10456-3402
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Country | US
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Telephone |
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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 | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 160569
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 160569
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License Number State | NY
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