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General NPI Number Information
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NPI Number | 1518155688
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Entity Type | Organization
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Legal Business Name | WILCK SCHWARTZ & NOVAK OD PC
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Dates
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Enumeration Date | 10/14/2007
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Last Update Date | 11/07/2013
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Provider Practice Location Address
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Address Line | 445 KINGS HWY 1ST FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11223-1780
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Country | US
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Telephone | 718-376-5288
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Fax | 718-382-0263
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Provider Business Mailing Address
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Address Line | 445 KINGS HWY 1ST FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11223-1780
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Country | US
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Telephone | 718-376-5288
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Fax |
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Authorized Official
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Title or Position | OD
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Name | DR. VLAD NOVAK
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Credential | OD
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Telephone | 718-376-5288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 002967
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License Number State | NY
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