Provider Demographics
NPI:1588786297
Name:NOVOTNY, HAROLD ROBERT
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:ROBERT
Last Name:NOVOTNY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1736 OAK CREEK DRIVE
Mailing Address - Street 2:APT 405
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-2115
Mailing Address - Country:US
Mailing Address - Phone:650-328-2219
Mailing Address - Fax:
Practice Address - Street 1:1736 OAK CREEK DRIVE
Practice Address - Street 2:APT 405
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-2115
Practice Address - Country:US
Practice Address - Phone:650-328-2219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01019476A2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry