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NPI Code Detail

MEDICARE: NUVANCE HEALTH MEDICAL PRACTICE, PC

MEDICARE: NUVANCE HEALTH MEDICAL PRACTICE, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1134469836
Entity Type Code : Organization
Provider Name (Legal Business Name) : NUVANCE HEALTH MEDICAL PRACTICE, PC
Provider Business Mailing Address
First Line : 1351 ROUTE 55 SUITE 200
Second Line :
City : LAGRANGEVILLE
State : NY
Zip : 12540-5108
Country : US
Telephone Number : 845-475-9661
Fax Number : 845-475-9938
Provider Business Practice Location Address
First Line : 4068 ALBANY POST RD
Second Line :
City : HYDE PARK
State : NY
Zip : 12538-3900
Country : US
Telephone Number : 845-229-2123
Fax Number : 845-229-6313
Authorized Official
Title or Position : VP FINANCE
Name : KAREN DARCY
Credential :
Telephone Number : 203-739-4593
Provider Enumeration Date : 02/18/2013
Last Update Date : 06/09/2021

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Directions to “NUVANCE HEALTH MEDICAL PRACTICE, PC ” Practice Location

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