Healthcare Provider Details

I. General information

NPI: 1124182639
Provider Name (Legal Business Name): RICHARD S. CASDEN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 11/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 NORTH ST SUITE 415
DANBURY CT
06810-5660
US

IV. Provider business mailing address

57 NORTH ST SUITE 415
DANBURY CT
06810-5660
US

V. Phone/Fax

Practice location:
  • Phone: 203-794-0117
  • Fax: 203-798-7048
Mailing address:
  • Phone: 203-794-0117
  • Fax: 203-798-7048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number019603
License Number StateCT

VIII. Authorized Official

Name: DR. RICHARD S CASDEN
Title or Position: OWNER
Credential: M.D.
Phone: 203-794-0117