Basic Information
| Provider Information | |||||||||
| NPI: | 1992980536 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AFONSO | ||||||||
| FirstName: | FERNANDO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24 HOSPITAL AVE | ||||||||
| Address2: | |||||||||
| City: | DANBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068106099 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037396959 | ||||||||
| FaxNumber: | 2037499031 | ||||||||
| Practice Location | |||||||||
| Address1: | 24 HOSPITAL AVE | ||||||||
| Address2: | |||||||||
| City: | DANBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037396959 | ||||||||
| FaxNumber: | 2037396495 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2008 | ||||||||
| LastUpdateDate: | 07/11/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 49205 | CT | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 049205 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.