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General NPI Number Information
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NPI Number | 1003186651
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Entity Type | Organization
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Legal Business Name | CHARLES L. G. HALASZ, MD
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 01/12/2012
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Provider Practice Location Address
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Address Line | 149 EAST AVE SUITE 20
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City | NORWALK
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State | CT
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Zip | 06851-5711
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Country | US
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Telephone | 203-853-1874
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Fax | 203-831-0007
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Provider Business Mailing Address
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Address Line | 149 EAST AVE SUITE 20
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City | NORWALK
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State | CT
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Zip | 06851-5711
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Country | US
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Telephone | 203-853-1874
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Fax | 203-831-0007
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. CHARLES LUDVIG HALASZ
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Credential | M.D.
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Telephone | 203-853-1874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 004551
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License Number State | CT
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