MEDICARE: DR. ANDREW MARK NOVICK DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	OS022030	PA
2	2084N0400X	Neurology Physician	100738	MT
3	2084N0400X	Neurology Physician	2021046265	MO
4	2084N0400X	Neurology Physician	T7316	TX
5	2084N0400X	Neurology Physician	305084	NY
6	2084N0400X	Neurology Physician	22266	NH
7	2084N0400X	Neurology Physician	DO207208	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316568728
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW MARK NOVICK DO

Provider Business Mailing Address
First Line	:	30 S ADELAIDE AVE APT PHB
Second Line	:
City	:	HIGHLAND PARK
State	:	NJ
Zip	:	08904-1606
Country	:	US
Telephone Number	:	516-974-4511
Fax Number	:

Provider Business Practice Location Address
First Line	:	15050 ELDERBERRY LN
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-8504
Country	:	US
Telephone Number	:	866-785-7769
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2020
Last Update Date	:	09/09/2025

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Directions to “ DR. ANDREW MARK NOVICK DO” Practice Location

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