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General NPI Number Information
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NPI Number | 1518746379
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Entity Type | Organization
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Legal Business Name | NOVELLA INFUSION LLC
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Dates
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Enumeration Date | 09/21/2023
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Last Update Date | 09/21/2023
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Provider Practice Location Address
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Address Line | 780 LYNNHAVEN PKWY STE 400
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-7332
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Country | US
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Telephone | 603-836-9869
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Fax | 603-836-0118
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Provider Business Mailing Address
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Address Line | 360 US HIGHWAY 1 BYP UNIT 102
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City | PORTSMOUTH
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State | NH
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Zip | 03801-7105
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOSEPH BRUNINK
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Credential |
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Telephone | 616-514-7350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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