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General NPI Number Information
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NPI Number | 1811409386
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Entity Type | Organization
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Legal Business Name | LISA NOVAK, NURSE PRACTITIONER IN PSYCHIATRY, PLLC
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Dates
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Enumeration Date | 10/24/2017
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 35 E GRASSY SPRAIN RD STE 304B
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City | YONKERS
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State | NY
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Zip | 10710-4618
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Country | US
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Telephone | 914-771-4009
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Fax | 914-771-4110
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Provider Business Mailing Address
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Address Line | 1585 CENTRAL PARK AVE UNIT 25
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City | YONKERS
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State | NY
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Zip | 10710-7402
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Country | US
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Telephone | 914-771-4009
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Fax | 914-771-4110
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | LISA NOVAK
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Credential | DNP, NPP-BC
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Telephone | 914-771-4009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | F401402
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License Number State | NY
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