Provider Demographics
NPI:1295910966
Name:DANBURY OFFICE OF PHYSICIAN SERVICES
Entity type:Organization
Organization Name:DANBURY OFFICE OF PHYSICIAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-797-7007
Mailing Address - Street 1:24 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6099
Mailing Address - Country:US
Mailing Address - Phone:203-797-7007
Mailing Address - Fax:203-739-8959
Practice Address - Street 1:18 GREAT PLAIN RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5022
Practice Address - Country:US
Practice Address - Phone:203-790-2209
Practice Address - Fax:203-790-2270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT039905273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT11659637OtherCAQH NUMBER
CTI57929OtherUPIN #