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General NPI Number Information
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NPI Number | 1972845048
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Entity Type | Individual
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Provider Name | MICHAEL NOWAK M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/26/2013
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Last Update Date | 12/18/2023
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Provider Practice Location Address
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Address Line | 1425 MADISON AVE
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City | NEW YORK
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State | NY
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Zip | 10029-6514
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Country | US
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Telephone | 212-241-0440
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Fax |
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Provider Business Mailing Address
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Address Line | ONE GUSTAVE L. LEVY PLACE, BOX 1122
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City | NEW YORK
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State | NY
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Zip | 10029
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Country | US
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Telephone | 212-241-0440
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 109623
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207ZM0300X
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Taxonomy Name | Medical Microbiology Physician
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License Number | 109623
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License Number State | NY
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