Noviawaty, Ika

Noviawaty, Ika is an individual health care provider with primary practice located at 725 Albany Street, Suite 7B Shapiro Building, Boston MA 02118. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical Neurophysiology, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Clinical Neurophysiology is her primary health care specialty. Noviawaty, Ika can be contacted via phone (617) 638-8456.

Contact Information

Primary practice address
725 Albany Street, Suite 7B Shapiro Building Boston MA 02118
Phone: (617) 638-8456
Fax: (617) 638-8465
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Clinical Neurophysiology 2084N0600X 265068 Massachusetts
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 265068 Massachusetts

Profile Details

NPI number 1265675292
LBN Legal business name Noviawaty, Ika
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2009
Last updated Jul 8th, 2024 - about 4 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265675292 NPPES
New Hampshire MEDICAID 3104891
New Hampshire MEDICAID 110108436A

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