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1992843528 NPI number — MARK ANTHONY NOVITSKY SR. M.D.

NPI Number: 1992843528
Health Care Provider/Practitioner: MARK ANTHONY NOVITSKY SR. M.D.

Information about “1992843528” NPI (MARK ANTHONY NOVITSKY SR. M.D.) exists in 1992843528 in HTML format HTML  |  1992843528 in plain Text format TXT  |  1992843528 in PDF (Portable Document Format) PDF  |  1992843528 in an XML format XML  formats.

NPI Number : 1992843528 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1992843528",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "NOVITSKY",
    "FirstName": "MARK",
    "MiddleName": "ANTHONY",
    "NamePrefix": "DR.",
    "NameSuffix": "SR.",
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1110 ASHRIDGE CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "AMBLER",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "19002-1821",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "215-870-6689",
    "MailingAddressFaxNumber": "215-542-7623",
    "FirstLinePracticeLocationAddress": "501 S 54TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PHILADELPHIA",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "19143-1900",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "215-870-6689",
    "PracticeLocationAddressFaxNumber": "215-542-7623",
    "EnumerationDate": "02/03/2007",
    "LastUpdateDate": "07/09/2007",
    "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": "2084P0800X",
          "TaxonomyName": "Psychiatry Physician",
          "LicenseNumber": "MD-029856-E",
          "LicenseNumberStateCode": "PA",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "2084P0800X",
          "TaxonomyName": "Psychiatry Physician",
          "LicenseNumber": "25MA07602200",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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