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:
Health care specialties
| Specialty | Code | License # | 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 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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