Provider Demographics
NPI:1184851669
Name:FCI DANBURY
Entity Type:Organization
Organization Name:FCI DANBURY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH SERVICES ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DARIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, MT
Authorized Official - Phone:203-312-5350
Mailing Address - Street 1:33 1/2 PEMBROKE RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-2954
Mailing Address - Country:US
Mailing Address - Phone:203-312-5350
Mailing Address - Fax:
Practice Address - Street 1:33 1/2 PEMBROKE RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-2954
Practice Address - Country:US
Practice Address - Phone:203-312-5350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2400XAmbulatory Health Care FacilitiesClinic/CenterPrison Health