Healthcare Provider Details

I. General information

NPI: 1609940741
Provider Name (Legal Business Name): NANCY WANG-D'AMATO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 TRIANGLE ST BUILDING I-4
DANBURY CT
06810-6977
US

IV. Provider business mailing address

78 TRIANGLE ST BUILDING I-4
DANBURY CT
06810-6977
US

V. Phone/Fax

Practice location:
  • Phone: 203-448-3152
  • Fax: 203-448-3135
Mailing address:
  • Phone: 203-448-3152
  • Fax: 203-448-3135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3503
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3503
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: