LARRY IRA NOVAK MD. NPI 1750303913

NPI Information

  • NPI: 1750303913
  • Provider Name: LARRY IRA NOVAK, MD.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 4104 MEDICAL CENTER DR
    SUITE 104
    FAYETTEVILLE, NY
    ZIP 13066
  • Phone: (315) 663-0059

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NPI Details

Larry Ira Novak, MD. is a family medicine in Fayetteville, NY. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Larry Ira Novak, MD. NPI is 1750303913. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4104 MEDICAL CENTER DR
SUITE 104
FAYETTEVILLE, NY
ZIP 13066-635
Phone: (315) 663-0059
Fax: (315) 663-0123

The NPI 1750303913 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/24/2006 and was last updated on 1/9/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine129876NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1RA8170MEDICARE PINNEW YORK
2080104359MEDICARE PINNEW YORK
3D02084MEDICARE UPINNEW YORK
400482435MEDICAIDNEW YORK
556564GMEDICARE PINNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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