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INTEGRATED MEDICAL OF DANBURY LLC NPI 1649403320


NPI Information

NPI: 1649403320
Provider Name: INTEGRATED MEDICAL OF DANBURY, LLC
Classification: Neuromusculoskeletal Medicine, Sports Medicine - 204C00000X
Entity Type: Organization

CLIA Number: 07D2201083

Address:
46 MILL PLAIN RD
DANBURY, CT
ZIP 06811
Phone: (203) 297-6120
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INTEGRATED MEDICAL OF DANBURY, LLC is a neuromusculoskeletal medicine sports medicine in Danbury, CT. The provider is definition to come. INTEGRATED MEDICAL OF DANBURY, LLC NPI is 1649403320. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

46 MILL PLAIN RD
DANBURY, CT
ZIP 06811-140
Phone: (203) 297-6120
Fax: (203) 297-6122

The provider's authorized official is Michael Lance Gerstenfeld .
The authorized official title is Owner/manager and has the following contact phone number (203) 297-6120.

The CLIA number assigned to this NPI record is 07D2201083 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/28/2009 and was last updated on 9/16/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1204C00000XNeuromusculoskeletal Medicine, Sports Medicine031959CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1F36301MEDICARE UPINCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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