Individual
JAN NOVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
462 GRIDER ST, BUFFALO, NY 14215-3021
(716) 898-3391
Mailing address
462 GRIDER ST, BUFFALO, NY 14215-3021
(716) 898-3391
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
109754
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010128301
EXCELLUS UNIVERA
NY
01
—
000507825003
HEALTH NOW
NY
05
—
00626811
—
NY
01
—
2306955
INDEPENDENT HEALTH
NY
Enumeration date
06/03/2006
Last updated
11/23/2011
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