Healthcare Provider Details

I. General information

NPI: 1902007438
Provider Name (Legal Business Name): ARCHNA JOHAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARCHNA PRASAD MD

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 03/29/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 WATERBURY RD STE 201
PROSPECT CT
06712-1247
US

IV. Provider business mailing address

69 SAND PIT RD
DANBURY CT
06810-4004
US

V. Phone/Fax

Practice location:
  • Phone: 203-791-2020
  • Fax: 203-758-7400
Mailing address:
  • Phone: 203-791-2020
  • Fax: 203-778-6238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number048718
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number048718
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: