Healthcare Provider Details

I. General information

NPI: 1205783073
Provider Name (Legal Business Name): NOVAL WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2068 BRIDGEPORT AVE STE D
MILFORD CT
06460-4634
US

IV. Provider business mailing address

2068 BRIDGEPORT AVE STE D
MILFORD CT
06460-4634
US

V. Phone/Fax

Practice location:
  • Phone: 475-549-1260
  • Fax:
Mailing address:
  • Phone: 475-549-1260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHANDEL REITH
Title or Position: OWNER
Credential: APRN
Phone: 814-251-5810