Provider Demographics
NPI:1992910566
Name:ALCANTARA, AURORA F (MD)
Entity type:Individual
Prefix:DR
First Name:AURORA
Middle Name:F
Last Name:ALCANTARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AURORA
Other - Middle Name:
Other - Last Name:ALCANTARA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:38 OLD RIDGEBURY RD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5128
Mailing Address - Country:US
Mailing Address - Phone:203-792-4515
Mailing Address - Fax:203-748-2604
Practice Address - Street 1:38 OLD RIDGEBURY RD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5128
Practice Address - Country:US
Practice Address - Phone:203-792-4515
Practice Address - Fax:203-748-2604
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT024416101YA0400X, 103TA0400X, 103TC0700X, 2084P0800X
CTSA-0215103TA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004188282Medicaid
CT004191962Medicaid
CT004238764Medicaid
CT004123840Medicaid
CT004258366Medicaid
CT004258374Medicaid
CT004257516Medicaid
CT004259025Medicaid
CT004052023Medicaid