Individual
GREGORY R NOVOTNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1175 DEHIRSCH AVE, WOODBINE, NJ 08270-2401
(609) 861-2164
Mailing address
1175 DEHIRSCH AVE, WOODBINE, NJ 08270-2401
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MB05370500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8060606
—
NJ
Enumeration date
07/10/2006
Last updated
02/21/2019
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