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Organization
DANBURY PHYSICAL MEDICINE AND REHABILITATION PC
Active
Organization
DANBURY PHYSICAL MEDICINE AND REHABILITATION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NIKKI C BLAYZOR (MANAGER)
(203) 207-9840
Entity
Organization
Contact information
Practice address
109 NEWTON RD, SUITE 1, DANBURY, CT 06810-4120
(203) 207-9840
(203) 207-9849
Mailing address
109 NEWTON RD, SUITE 1, DANBURY, CT 06810-4120
(203) 207-9840
(203) 207-9849
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
043130
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D100007621
MEDICARE PTAN
CT
Enumeration date
03/12/2009
Last updated
12/02/2009
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