NPI Code Detail JSON Logo

1619951282 NPI number — BRIAN D NOWAK MD

NPI Number: 1619951282
Health Care Provider/Practitioner: BRIAN D NOWAK MD

Information about “1619951282” NPI (BRIAN D NOWAK MD) exists in 1619951282 in HTML format HTML  |  1619951282 in plain Text format TXT  |  1619951282 in PDF (Portable Document Format) PDF  |  1619951282 in an XML format XML  formats.

NPI Number : 1619951282 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1619951282",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "NOWAK",
    "FirstName": "BRIAN",
    "MiddleName": "D",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3 BOYLE RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SELDEN",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11784-4030",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "631-736-4064",
    "MailingAddressFaxNumber": "631-736-1332",
    "FirstLinePracticeLocationAddress": "1000 MONTAUK HWY",
    "SecondLinePracticeLocationAddress": "GOOD SAMARITAN HOSPITAL MEDICAL CENTER",
    "PracticeLocationAddressCityName": "WEST ISLIP",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11795-4927",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "631-736-4064",
    "PracticeLocationAddressFaxNumber": "631-736-1332",
    "EnumerationDate": "12/06/2005",
    "LastUpdateDate": "09/07/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "180354",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "50905",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": "25MA09149000",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2025 Data Labs Health. All rights reserved.