Healthcare Provider Details

I. General information

NPI: 1982264644
Provider Name (Legal Business Name): VANESSA MAGGIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2019
Last Update Date: 08/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 HOSPITAL AVE
DANBURY CT
06810
US

IV. Provider business mailing address

7 GINGHAM CT
DANBURY CT
06810-1516
US

V. Phone/Fax

Practice location:
  • Phone: 203-739-7188
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number126259
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number12
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number8259
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: