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NPI Code Detail

MEDICARE: ADVENIENTISHEALTH LLC

MEDICARE: ADVENIENTISHEALTH LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1780529719
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVENIENTISHEALTH LLC
Provider Business Mailing Address
First Line : 821 N ST STE 102
Second Line :
City : ANCHORAGE
State : AK
Zip : 99501-3285
Country : US
Telephone Number : 907-313-2793
Fax Number :
Provider Business Practice Location Address
First Line : 196 MILL RD
Second Line :
City : NORTH HAVEN
State : CT
Zip : 06473-3422
Country : US
Telephone Number : 907-313-2793
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. LUKASZ NOSOL
Credential :
Telephone Number : 907-313-2793
Provider Enumeration Date : 04/23/2026
Last Update Date : 04/23/2026

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Directions to “ADVENIENTISHEALTH LLC ” Practice Location

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