Provider Demographics
NPI:1346492386
Name:CITY OF DANBURY
Entity Type:Organization
Organization Name:CITY OF DANBURY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAYOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:BOUGHTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-797-4510
Mailing Address - Street 1:155 DEER HILL AVE
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-7726
Mailing Address - Country:US
Mailing Address - Phone:203-797-4510
Mailing Address - Fax:203-796-1596
Practice Address - Street 1:21 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-8005
Practice Address - Country:US
Practice Address - Phone:203-778-7479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0481261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center