| Organization Name: | BRIAN J NOVACK DPM |
| NPI Number: | 1316092844 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRIAN J NOVACK (PRESIDENT) |
| Mailing Address: | 29630 Euclid Ave Wickliffe |
| State: | OH US |
| Postal Code: | 440921829 |
| Phone Number: | 4409446665 |
| Fax Number: | 4409446672 |
| NPI Enumeration Date: | 01/24/2007 |
| NPI Last Update Date: | 11/01/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | 36001391N |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |