Healthcare Provider Details

I. General information

NPI: 1740665843
Provider Name (Legal Business Name): HVRA OF DANBURY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2015
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 SAND PIT RD STE 102
DANBURY CT
06810-4032
US

IV. Provider business mailing address

67 SAND PIT RD
DANBURY CT
06810-4032
US

V. Phone/Fax

Practice location:
  • Phone: 203-797-1770
  • Fax: 203-207-3242
Mailing address:
  • Phone: 203-797-1770
  • Fax: 203-207-3242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335V00000X
TaxonomyPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
License Number
License Number State

VIII. Authorized Official

Name: HOWARD LEE
Title or Position: PRESIDENT
Credential: MD
Phone: 845-278-6200