Provider Demographics
NPI:1992553135
Name:NOVAK, DEBORAH J
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:J
Last Name:NOVAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1187 LOCUST CORNER RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45245-3008
Mailing Address - Country:US
Mailing Address - Phone:513-476-8827
Mailing Address - Fax:
Practice Address - Street 1:1187 LOCUST CORNER RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45245-3008
Practice Address - Country:US
Practice Address - Phone:513-476-8827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant