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General NPI Number Information
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NPI Number | 1891399770
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Entity Type | Individual
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Provider Name | NICOLE EMILY NAVE
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Gender | Female
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Dates
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Enumeration Date | 11/23/2020
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Last Update Date | 11/24/2020
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Provider Practice Location Address
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Address Line | 84 OXFORD RD RT 67
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City | OXFORD
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State | CT
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Zip | 06478-1971
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Country | US
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Telephone | 203-881-0830
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Fax | 203-881-0894
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Provider Business Mailing Address
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Address Line | 1625 STRAITS TPKE STE 300
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City | MIDDLEBURY
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State | CT
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Zip | 06762-1836
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Country | US
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Telephone | 203-598-0600
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Fax | 203-598-3300
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2125
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2125
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License Number State | CT
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