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Individual

DR. MARK DOUGLAS NOVICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
61 E 77TH ST, NYC, NY 10075-1902
(212) 772-3111
Mailing address
61 E 77TH ST, NEW YORK, NY 10075-1817
(212) 772-3111

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
166374-1
NY
2085R0202X
Diagnostic Radiology Physician
Primary
ME97607
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002800400
FL
05
01015021
NY
05
109355800
FL
Enumeration date
05/12/2006
Last updated
05/11/2026
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