Healthcare Provider Details

I. General information

NPI: 1942126719
Provider Name (Legal Business Name): NYANGE MEDICAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 BROADWAY STE R
ALBANY NY
12207-2922
US

IV. Provider business mailing address

418 BROADWAY STE R
ALBANY NY
12207-2922
US

V. Phone/Fax

Practice location:
  • Phone: 929-243-4707
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTABEL ELINSA NYANGE
Title or Position: AUTHORIZED OFFICIAL
Credential: MD, MPH
Phone: 929-243-4707