Healthcare Provider Details

I. General information

NPI: 1407937824
Provider Name (Legal Business Name): EILEEN M MADSEN RNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 W MAIN ST
STAMFORD CT
06902-4536
US

IV. Provider business mailing address

29 HOSPITAL PLZ STE 604
STAMFORD CT
06902-3602
US

V. Phone/Fax

Practice location:
  • Phone: 203-863-3671
  • Fax: 203-863-4758
Mailing address:
  • Phone: 203-323-8989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number001819
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: