Healthcare Provider Details

I. General information

NPI: 1184225906
Provider Name (Legal Business Name): NUVANCE HEALTH MEDICAL PRACTICE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2020
Last Update Date: 06/09/2021
Certification Date: 06/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 WESTAGE BUSINESS CTR DR STE 230
FISHKILL NY
12524-2288
US

IV. Provider business mailing address

1351 ROUTE 55 STE 200
LAGRANGEVILLE NY
12540-5128
US

V. Phone/Fax

Practice location:
  • Phone: 845-790-1380
  • Fax: 845-790-1977
Mailing address:
  • Phone: 845-475-9661
  • Fax: 845-475-9938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: KAREN DARCY
Title or Position: VP FINANCE
Credential:
Phone: 203-739-4593