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General NPI Number Information
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NPI Number | 1104344340
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Entity Type | Organization
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Legal Business Name | NUVANCE HEALTH MEDICAL PRACTICE, PC
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Dates
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Enumeration Date | 09/08/2017
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Last Update Date | 04/09/2021
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Provider Practice Location Address
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Address Line | 150 ROUTE 52
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City | CARMEL
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State | NY
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Zip | 10512-1200
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Country | US
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Telephone | 845-228-2910
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Fax | 845-228-2914
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Provider Business Mailing Address
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Address Line | 1351 ROUTRE 55 SUITE 200
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City | LAGRANGEVILLE
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State | NY
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Zip | 12540
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Country | US
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Telephone | 845-475-9661
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Fax | 845-475-9635
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Authorized Official
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Title or Position | VP FINANCE
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Name | KAREN DARCY
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Credential |
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Telephone | 203-739-4593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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