Healthcare Provider Details

I. General information

NPI: 1730210303
Provider Name (Legal Business Name): AMIR R NASIR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 NEWTOWN RD STE 2C
DANBURY CT
06810-4146
US

IV. Provider business mailing address

107 NEWTOWN RD STE 2C
DANBURY CT
06810-4146
US

V. Phone/Fax

Practice location:
  • Phone: 203-830-4700
  • Fax: 203-730-4162
Mailing address:
  • Phone: 203-830-4700
  • Fax: 203-730-4162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberM-14559
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number22732
License Number StateND
# 3
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number051774
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: