Individual
DR. DAVID J NOVELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2731 TRANSIT RD STE 107, ELMA, NY 14059-9039
(716) 677-4178
(855) 816-9607
Mailing address
2731 TRANSIT RD STE 107, ELMA, NY 14059-9039
(716) 677-4178
(855) 816-9607
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
128300-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00617294
—
NY
01
—
128300-1
LICENSE
NY
01
—
16-1172119
TAX ID
NY
01
—
33D0949004
CLIA
NY
Enumeration date
03/28/2006
Last updated
03/07/2023
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