Provider Demographics
NPI:1396802278
Name:NOVAKY, DENISE D (PHD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:D
Last Name:NOVAKY
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 1:116 HIGH STREET
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-1937
Mailing Address - Country:US
Mailing Address - Phone:908-813-2455
Mailing Address - Fax:908-813-2403
Practice Address - Street 1:116 HIGH STREET
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-1937
Practice Address - Country:US
Practice Address - Phone:908-813-2455
Practice Address - Fax:908-813-2403
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2768103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ079753Medicare ID - Type UnspecifiedPSYCHOLOGIST