Healthcare Provider Details

I. General information

NPI: 1043960206
Provider Name (Legal Business Name): BANYA MYO WIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 MAIN ST
DANBURY CT
06810-7832
US

IV. Provider business mailing address

70 MAIN ST
DANBURY CT
06810-7832
US

V. Phone/Fax

Practice location:
  • Phone: 203-456-1405
  • Fax: 866-800-7321
Mailing address:
  • Phone: 203-456-1405
  • Fax: 866-800-7321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number81683
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: