Healthcare Provider Details

I. General information

NPI: 1932102803
Provider Name (Legal Business Name): JAMES E BABASHAK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 09/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 STEVENS ST
NORWALK CT
06850-3852
US

IV. Provider business mailing address

12 DEFOREST LN
WILTON CT
06897-1906
US

V. Phone/Fax

Practice location:
  • Phone: 203-852-2276
  • Fax: 203-852-2527
Mailing address:
  • Phone: 203-761-1202
  • Fax: 203-761-1202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number043108
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: