Provider Demographics
NPI:1407898117
Name:NUVANCE HEALTH MEDICAL PRACTICE CT, INC.
Entity type:Organization
Organization Name:NUVANCE HEALTH MEDICAL PRACTICE CT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP CORE FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-739-7127
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:203-794-5341
Mailing Address - Fax:
Practice Address - Street 1:24 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6099
Practice Address - Country:US
Practice Address - Phone:203-739-7742
Practice Address - Fax:203-739-8731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Multi-Specialty
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1407898117OtherDANBURY OPS- ANESTHESIA
CA9077OtherRAILROAD MEDICARE
CN0754OtherRAILROAD MEDICARE
CA9877OtherRAILROAD MEDICARE
CB9877OtherRAILROAD MEDICARE
DB7813OtherRAILROAD MEDICARE
DB7784OtherRAILROAD MEDICARE
CD5194OtherRAILROAD MEDICARE
CI1332OtherRAILROAD MEDICARE
DA9877OtherRAILROAD MEDICARE
CTC00836Medicare PIN
CTC00824Medicare PIN
CD5194OtherRAILROAD MEDICARE
CTC00709Medicare PIN
CTC01846Medicare PIN
DA9877OtherRAILROAD MEDICARE
CA9077OtherRAILROAD MEDICARE
CTC00984Medicare PIN
CTCA3680Medicare PIN