Healthcare Provider Details

I. General information

NPI: 1295910966
Provider Name (Legal Business Name): DANBURY OFFICE OF PHYSICIAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2007
Last Update Date: 12/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 GREAT PLAIN RD
DANBURY CT
06810-5022
US

IV. Provider business mailing address

24 HOSPITAL AVE
DANBURY CT
06810-6099
US

V. Phone/Fax

Practice location:
  • Phone: 203-790-2209
  • Fax: 203-790-2270
Mailing address:
  • Phone: 203-797-7007
  • Fax: 203-739-8959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number039905
License Number StateCT

VIII. Authorized Official

Name: DR. ROBERT MAHLER
Title or Position: PSYCHIATRIST
Credential: M.D.
Phone: 203-797-7007