Healthcare Provider Details
I. General information
NPI: 1740860279
Provider Name (Legal Business Name): LINDA AWUOR OTIENO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/09/2021
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
24 HOSPITAL AVE
DANBURY CT
06810-6099
US
IV. Provider business mailing address
24 HOSPITAL AVE
DANBURY CT
06810-6099
US
V. Phone/Fax
- Phone: 203-739-7000
- Fax:
- Phone: 203-739-7000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | 83437 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: