Healthcare Provider Details

I. General information

NPI: 1598149098
Provider Name (Legal Business Name): HVRA OF NEW MILFORD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2015
Last Update Date: 07/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 KENT RD BLDG A SUITE 102
NEW MILFORD CT
06776-3485
US

IV. Provider business mailing address

67 SAND PIT RD SUITE 105
DANBURY CT
06810-4084
US

V. Phone/Fax

Practice location:
  • Phone: 860-355-4212
  • Fax: 860-355-4266
Mailing address:
  • Phone: 203-797-1770
  • Fax: 203-796-7839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CONRAD PAUL EHRLICH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 203-797-1770