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General NPI Number Information
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NPI Number | 1710436936
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Entity Type | Individual
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Provider Name | WENDY NOVICK DPT
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Gender | Female
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Dates
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Enumeration Date | 09/29/2016
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Last Update Date | 09/29/2016
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Provider Practice Location Address
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Address Line | 1280 ALMONESSON ROAD
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City | DEPTFORD
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State | NJ
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Zip | 08096
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Country | US
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Telephone | 856-345-1402
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Fax |
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Provider Business Mailing Address
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Address Line | 1280 ALMONESSON ROAD
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City | DEPTFORD
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State | NJ
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Zip | 08096
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Country | US
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Telephone | 856-345-1402
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | PT025079
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | J1-0002257
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 40QA01670000
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License Number State | NJ
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