Provider Demographics
NPI:1245565464
Name:NUVANCE HEALTH MEDICAL PRACTICE, PC
Entity Type:Organization
Organization Name:NUVANCE HEALTH MEDICAL PRACTICE, PC
Other - Org Name:URGENT CARE WAPP. FALLS
Other - Org Type:Other Name
Authorized Official - Title/Position:VP ACCOUNTING AND TREASURY
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DARCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-739-4593
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:
Practice Address - Street 1:1530 ROUTE 9
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-4131
Practice Address - Country:US
Practice Address - Phone:845-297-2511
Practice Address - Fax:845-297-4993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-06
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA100000134OtherMEDICARE PTAN