Provider Demographics
NPI:1932583630
Name:HVRA OF DANBURY, LLC
Entity Type:Organization
Organization Name:HVRA OF DANBURY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CONRAD
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:EHRLICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-797-1770
Mailing Address - Street 1:67 SAND PIT RD STE 105
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-4084
Mailing Address - Country:US
Mailing Address - Phone:203-797-1770
Mailing Address - Fax:203-790-7549
Practice Address - Street 1:67 SAND PIT RD
Practice Address - Street 2:SUITE 105
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-4084
Practice Address - Country:US
Practice Address - Phone:203-797-1770
Practice Address - Fax:203-796-7839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty