Healthcare Provider Details

I. General information

NPI: 1992910566
Provider Name (Legal Business Name): AURORA F ALCANTARA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AURORA ALCANTARA MD

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 02/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 OLD RIDGEBURY RD
DANBURY CT
06810-5128
US

IV. Provider business mailing address

38 OLD RIDGEBURY RD
DANBURY CT
06810-5128
US

V. Phone/Fax

Practice location:
  • Phone: 203-792-4515
  • Fax: 203-748-2604
Mailing address:
  • Phone: 203-792-4515
  • Fax: 203-748-2604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number024416
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number024416
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number024416
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberSA-0215
License Number StateCT
# 5
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number024416
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: