Healthcare Provider Details

I. General information

NPI: 1568646289
Provider Name (Legal Business Name): DANBURY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2007
Last Update Date: 12/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 HOSPITAL AVE
DANBURY CT
06810-6099
US

IV. Provider business mailing address

1224 AVALON VALLEY DR
DANBURY CT
06810-4048
US

V. Phone/Fax

Practice location:
  • Phone: 203-739-7338
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW MILLER
Title or Position: CHIEF MEDICAL OFFICER
Credential:
Phone: 203-739-7322