1740387182 NPI number — WESTERN CONNECTICUT HEALTH NETWORK AFFILIATES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740387182 NPI number — WESTERN CONNECTICUT HEALTH NETWORK AFFILIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WESTERN CONNECTICUT HEALTH NETWORK AFFILIATES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740387182
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/15/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
24 HOSPITAL AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DANBURY
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06810
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-894-1444
Provider Business Mailing Address Fax Number:
203-739-8199

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
901 ETHAN ALLEN HIGHWAY
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
RIDGEFIELD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06877
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-894-1444
Provider Business Practice Location Address Fax Number:
203-739-8199
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DEBARBA
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
203-739-7240

Provider Taxonomy Codes

  • Taxonomy code: 261QR0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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