Provider Demographics
NPI:1386950376
Name:NOVITSKIE, DOROTA W (PHD)
Entity type:Individual
Prefix:DR
First Name:DOROTA
Middle Name:W
Last Name:NOVITSKIE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ALPINE RD
Mailing Address - Street 2:
Mailing Address - City:BOONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07005-9743
Mailing Address - Country:US
Mailing Address - Phone:973-906-3431
Mailing Address - Fax:201-270-5135
Practice Address - Street 1:140 COUNTY RD
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-1839
Practice Address - Country:US
Practice Address - Phone:973-906-3431
Practice Address - Fax:201-270-5135
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021114103T00000X
NJ35SI00547400103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist