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General NPI Number Information
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NPI Number | 1538427919
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Entity Type | Organization
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Legal Business Name | BRIAN D NOWAK MD PC
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 04/24/2012
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Provider Practice Location Address
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Address Line | 3 BOYLE RD
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City | SELDEN
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State | NY
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Zip | 11784-4000
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Country | US
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Telephone | 631-736-4064
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Fax | 631-736-1332
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Provider Business Mailing Address
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Address Line | 3 BOYLE RD
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City | SELDEN
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State | NY
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Zip | 11784-4000
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Country | US
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Telephone | 631-736-4064
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Fax | 631-736-1332
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIAN NOWAK
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Credential | MD
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Telephone | 631-736-4064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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