Healthcare Provider Details

I. General information

NPI: 1033444260
Provider Name (Legal Business Name): NUVANCE HEALTH MEDICAL PRACTICE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2009
Last Update Date: 04/12/2022
Certification Date: 04/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 ROUTE 55 SUITE 101
LAGRANGEVILLE NY
12540-5049
US

IV. Provider business mailing address

100 RESERVE RD
DANBURY CT
06810-5267
US

V. Phone/Fax

Practice location:
  • Phone: 845-485-4455
  • Fax: 845-485-4472
Mailing address:
  • Phone: 845-475-9661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KAREN DARCY
Title or Position: VP ACCOUNTING AND TREASURY
Credential:
Phone: 203-739-4593