Nisenbaum, Michelle

Nisenbaum, Michelle is an individual health care provider with primary practice located at 1320 West Main St Bldg 2, Waterbury CT 06708. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is her primary health care specialty. Nisenbaum, Michelle can be contacted via phone (203) 755-9355.

Contact Information

Primary practice address
1320 West Main St Bldg 2 Waterbury CT 06708
Phone: (203) 755-9355
Fax: (203) 597-8192
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X 043409 Connecticut
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 043409 Connecticut

Profile Details

NPI number 1639259252
LBN Legal business name Nisenbaum, Michelle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2006
Last updated Sep 12th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639259252 NPPES
Other 3821999 AETNA US HEALTH CARE
Other P00296425 AETNA US HEALTH CARE
Other 2771432 AETNA US HEALTH CARE
Other 2V7481 AETNA US HEALTH CARE
Other 2525598 AETNA US HEALTH CARE
MEDICAID 001434092 AETNA US HEALTH CARE
Other 010043409CT01 AETNA US HEALTH CARE
Other P3673144 AETNA US HEALTH CARE
Other 043409 AETNA US HEALTH CARE

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