MEDICARE: DR. DENISE NOVAES M.D.

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	208000000X	Pediatrics Physician	MA06906700	NJ

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	:	1447257225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENISE NOVAES M.D.

Provider Business Mailing Address
First Line	:	LB#7550, PO BOX 95000
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19195-3130
Country	:	US
Telephone Number	:	844-362-1735
Fax Number	:	973-290-7495

Provider Business Practice Location Address
First Line	:	328A SPARTA AVE
Second Line	:
City	:	SPARTA
State	:	NJ
Zip	:	07871-1166
Country	:	US
Telephone Number	:	973-729-2197
Fax Number	:	973-729-3653

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	08/27/2020

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