Glenn J. Novak D O Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

03058 Issued in OH

Legal business name

GLENN J. NOVAK D O INC

Practice address

51 Westchester Dr
Youngstown, OH 44515-3902

Phone

(330) 799-1718

Fax

(330) 799-8328

NPI assigned

May 18, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Glenn Joseph Novak, D.O.NPI 1750380788

Title

Physician

Phone

(330) 799-1718

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Glenn Joseph Novak, D.O.

  • Internal Medicine Physician
  • Youngstown, OH
  • NPI 1750380788
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274659200000",
    "number": "1205155199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 WESTCHESTER DR",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445153902",
            "telephone_number": "330-799-1718",
            "fax_number": "330-799-8328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 WESTCHESTER DR",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445153902",
            "telephone_number": "330-799-1718",
            "fax_number": "330-799-8328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN J. NOVAK D O INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-18",
        "last_updated": "2010-05-24",
        "status": "A",
        "authorized_official_last_name": "NOVAK",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "330-799-1718",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "03058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0766434",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Ann Givens
• Amy Gladman
• Shane Anthony Glaeser
• Andrew Thomas Glass
• Isabella Glenellen, LPCC
• Brian Glenn
• Celestine Glenn, MASSAGE THERAPIST
• Shayriss Glenn, OPTICIAN
• Global Hearing Solutions, LLC
• Rhonda Gluckner, RN, MSN

• Internal Medicine Physician in Youngstown, OH
• Providers in Youngstown, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.