Novalab Corp

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

NOVALAB CORP

Practice address

87 Berdan Ave
Suite #4
Wayne, NJ 07470-3210

Phone

(973) 832-7902

Fax

(973) 832-7980

NPI assigned

Sep 23, 2016

Last updated

Oct 19, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ildar Nizami

Title

Owner

Phone

(973) 832-7902

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Cesira Boni

  • Nutrition Education Nutritionist
  • Wayne, NJ
  • NPI 1669006607
  NPD
• Olga Y Shatkin, APN

  • Gerontology Nurse Practitioner
  • Wayne, NJ
  • NPI 1821816216
  NPD
• Alexis Rae Saley, APN

  • Adult Health Nurse Practitioner
  • Wayne, NJ
  • NPI 1427516244
  NPD (past)
• Tatiana Sharahy, M.D.

  • Internal Medicine Physician
  • Ridgewood, NJ
  • NPI 1598889248
  NPD (past)

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666137600000",
    "number": "1972052512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 BERDAN AVE",
            "address_2": "SUITE #4",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703210",
            "telephone_number": "973-832-7902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 BERDAN AVE",
            "address_2": "SUITE #4",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074703210",
            "telephone_number": "973-832-7902",
            "fax_number": "973-832-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVALAB CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-23",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A",
        "authorized_official_last_name": "NIZAMI",
        "authorized_official_first_name": "ILDAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-832-7902"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alicia R Notkin, MD
• Margaret Nowak, PT
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• Marissa Nucci, PT
• Alexis Nunez
• NV Medical Aesthetics

• Clinical Medical Laboratory in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Clinical Medical Laboratory in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; 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.