Provider Demographics
NPI:1083377048
Name:NUVANCE HEALTH MEDICAL PRACTICE, PC
Entity Type:Organization
Organization Name:NUVANCE HEALTH MEDICAL PRACTICE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTING/PAYER RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:JAYMA
Authorized Official - Middle Name:NOLAN
Authorized Official - Last Name:WASKIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-475-9661
Mailing Address - Street 1:100 RESERVE RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5267
Mailing Address - Country:US
Mailing Address - Phone:845-475-9661
Mailing Address - Fax:845-475-9938
Practice Address - Street 1:66 MIDDLEBUSH RD STE 302
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-4076
Practice Address - Country:US
Practice Address - Phone:845-790-1393
Practice Address - Fax:845-790-3104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty