Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 020516 | CT |
N | 207U00000X | Nuclear Medicine Specialist | 246260 | MA |
NPI | 1043296304 |
---|---|
Provider Name | Dr. Ronald J. Rosenberg |
First Address | East Hartford, CT 06108-3212 |
Second Address | Hartford, CT 06106-5501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2005 |
Last Update Date | 17/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001205162 | (05) | CT |
010020516CT01 | ANTHEM BC/BS (01) | CT |
A2516306 | OXFORD (01) | CT |
E45200 | (02) | CT |