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Individual

MARY S CHACHO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
24 HOSPITAL AVE, DANBURY, CT 06810-6099
(203) 739-7453
Mailing address
24 HOSPITAL AVE, DANBURY, CT 06810-6099
(203) 739-7453

Taxonomy

Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
Primary
027421
CT
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
027421
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001274216
CT
01
010027421CT03
ANTHEM BCBS
CT
01
042065
HEALTH NET
CT
01
1125923
AETNA US HEALTHCARE
CT
01
148535
OXFORD
CT
01
397884
CIGNA
CT
01
58R691
EMPIRE BCBS
NY
01
810730064
PHCS
CT
01
P00293964
RAILROAD MEDICARE
CT
Enumeration date
06/11/2006
Last updated
08/07/2013
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