Healthcare Provider Details

I. General information

NPI: 1427536101
Provider Name (Legal Business Name): MAR Y SOL MENTAL HEALTH EXPERTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2018
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 FEDERAL RD STE D
DANBURY CT
06810-6197
US

IV. Provider business mailing address

46 FEDERAL RD STE D
DANBURY CT
06810-6197
US

V. Phone/Fax

Practice location:
  • Phone: 203-456-6989
  • Fax: 203-826-7647
Mailing address:
  • Phone: 203-456-6989
  • Fax: 203-826-7647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: AURA MARIZOL ARDON
Title or Position: MD
Credential: MD
Phone: 718-290-5126