Provider Demographics
NPI:1275694903
Name:TOWN OF DARIEN
Entity Type:Organization
Organization Name:TOWN OF DARIEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HEALTH
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KNAUF
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:203-656-7324
Mailing Address - Street 1:2 RENSHAW RD
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-5344
Mailing Address - Country:US
Mailing Address - Phone:203-656-7320
Mailing Address - Fax:203-656-7486
Practice Address - Street 1:2 RENSHAW RD
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820
Practice Address - Country:US
Practice Address - Phone:203-656-7320
Practice Address - Fax:203-656-7486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT251300000X
CT251K00000X251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
990000647Medicare PIN