Healthcare Provider Details

I. General information

NPI: 1912829417
Provider Name (Legal Business Name): NOVENA T LANGLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 KNOX ST APT B2
WEST HAVEN CT
06516-2128
US

IV. Provider business mailing address

105 KNOX ST APT B2
WEST HAVEN CT
06516-2128
US

V. Phone/Fax

Practice location:
  • Phone: 203-435-1309
  • Fax:
Mailing address:
  • Phone: 203-435-1309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number10.172498
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: