Provider Information for 1073806980
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Ms. MAYA NOVOK LCSW-R
Sex: Female
NPI: 1073806980
Last Updated: 2022-07-16
Certification Date: 2022-07-07
Certification Date: 2022-07-07
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1073806980 | ||||||||||||
| Enumeration Date | 2011-05-25 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 6 ROMEO LN COMMACK, NY 11725-3818 United States Phone: 631-786-2142 | Fax: | ||||||||||||
| Primary Practice Address | 6 ROMEO LN COMMACK, NY 11725-3818 United States Phone: 631-786-2142 | Fax: | ||||||||||||
| Secondary Practice Address(es) | 57 BIRCHWOOD DR | ||||||||||||
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