Alexandre Victor Novikov

Primary specialty

Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X

License

118609 Issued in MD

Practice address

175 E Chester Pike
Ridley Park, PA 19078-2212

Phone

(610) 595-6467

NPI assigned

Apr 30, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556582400000",
    "number": "1225692718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 E CHESTER PIKE",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190782212",
            "telephone_number": "610-595-6467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E CHESTER PIKE",
            "city": "RIDLEY PARK",
            "state": "PA",
            "postal_code": "190782212",
            "telephone_number": "610-595-6467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVIKOV",
        "first_name": "ALEXANDRE",
        "middle_name": "VICTOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-30",
        "last_updated": "2019-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "MD",
            "license": "118609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonnie P Muetterties, CRNA
• Brooke Nasella
• Omer Salah Nasir, M.D.
• Megan A Nearing, PA-C
• New Truth Therapy, LLC
• Robert Dizon Nunag, MD
• Kevin O'Brienr, RPH
• Lacey M. O'Hara, PA-C
• Marlena O'Kane, LPC
• Sean O'Neill, BA

• Diagnostic Ultrasound Physician in Ridley Park, PA
• Providers in Ridley Park, PA by specialty
• Diagnostic Ultrasound Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.