Healthcare Provider Details

I. General information

NPI: 1649083478
Provider Name (Legal Business Name): ANDREA DAUR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 HOLLY HILL LN STE 102
GREENWICH CT
06830-2911
US

IV. Provider business mailing address

124 RITCH AVE W APT B203
GREENWICH CT
06830-6975
US

V. Phone/Fax

Practice location:
  • Phone: 203-863-4050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberE35916
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: