Provider Demographics
NPI:1558327338
Name:DANBURY SURGICAL CENTER LP
Entity Type:Organization
Organization Name:DANBURY SURGICAL CENTER LP
Other - Org Name:HEALTHSOUTH SURGERY CENTER OF DANBURY, L.P.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VP/SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:SHARFF
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:205-545-2572
Mailing Address - Street 1:73 SAND PIT RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-4042
Mailing Address - Country:US
Mailing Address - Phone:203-743-2400
Mailing Address - Fax:
Practice Address - Street 1:73 SAND PIT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-4042
Practice Address - Country:US
Practice Address - Phone:203-743-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0269261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004217685Medicaid
CT004217685Medicaid
CT490000222Medicare PIN