Healthcare Provider Details

I. General information

NPI: 1144569997
Provider Name (Legal Business Name): NUVANCE HEALTH MEDICAL PRACTICE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2013
Last Update Date: 06/09/2021
Certification Date: 06/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 READE PL JOSEPH TOWER, 1ST FLOOR
POUGHKEEPSIE NY
12601-3947
US

IV. Provider business mailing address

1351 ROUTE 55 SUITE 200
LAGRANGEVILLE NY
12540-5108
US

V. Phone/Fax

Practice location:
  • Phone: 845-483-6654
  • Fax: 845-483-6993
Mailing address:
  • Phone: 845-475-9661
  • Fax: 845-475-9938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

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