Organization
RAPHAEL NOVOGRODSKY MD PC
Active
Other names
RAPHAEL NOVOGRODSKY MD PC
Organization subpart
No
Provider details
NPI number
Authorized official
RAPHAEL NOVOGRODSKY M.D. (OWNER)
(201) 638-3640
Entity
Organization
Contact information
Practice address
1250 WATERS PL, SUITE 1207, BRONX, NY 10461
(718) 684-4482
(718) 918-9778
Mailing address
401 RUTLAND AVE, TEANECK, NJ 07666
(718) 684-4482
(718) 918-9778
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01497323
—
NY
Enumeration date
06/26/2023
Last updated
06/26/2023
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