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Organization
DANBURY MIDWIFERY GROUP LLC
Active
Organization
DANBURY MIDWIFERY GROUP LLC
Active
Other names
CCWC Professional Practice Group LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH PAUL BLAU MD (MANAGING PARTNER)
(203) 748-6000
Entity
Organization
Contact information
Practice address
94 LOCUST AVE, DANBURY, CT 06810-6032
(203) 748-6000
(203) 748-6771
Mailing address
94 LOCUST AVE, DANBURY, CT 06810-6032
(203) 748-6000
(203) 748-6771
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
030587
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00130587100
—
CT
Enumeration date
06/08/2016
Last updated
12/05/2022
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