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General NPI Number Information
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NPI Number | 1528931011
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Entity Type | Organization
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Legal Business Name | IMPACT HEALTH ADVANCED CARE PC
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Dates
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Enumeration Date | 09/29/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 240 INDIAN RIVER RD STE C7
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City | ORANGE
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State | CT
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Zip | 06477-3691
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Country | US
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Telephone | 203-497-3861
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Fax | 203-718-2381
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Provider Business Mailing Address
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Address Line | 240 INDIAN RIVER RD STE C7
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City | ORANGE
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State | CT
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Zip | 06477-3691
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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 | OWNER
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Name | MICHAEL BUXBAUM
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Credential | DO
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Telephone | 832-443-5092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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