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General NPI Number Information
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NPI Number | 1023283553
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Entity Type | Organization
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Legal Business Name | DANBURY OFFICE OF PHYSICIAN SERVICES
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Dates
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Enumeration Date | 04/25/2008
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Last Update Date | 04/25/2008
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Provider Practice Location Address
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Address Line | 24 HOSPITAL AVE
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City | DANBURY
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State | CT
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Zip | 06810-6099
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Country | US
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Telephone | 203-739-6810
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Fax | 203-739-6465
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Provider Business Mailing Address
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Address Line | 24 HOSPITAL AVE
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City | DANBURY
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State | CT
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Zip | 06810-6099
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Country | US
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Telephone | 203-739-6810
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Fax | 203-739-6465
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Authorized Official
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Title or Position | CREDENTIALING REPRESENTATIVE
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Name | KENNETH F OSWALD
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Credential |
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Telephone | 203-739-7433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State | CT
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