Individual
MYRA ROSENSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
65 KANE ST, INTERNAL MEDICINE, WEST HARTFORD, CT 06119-2110
(860) 523-6436
(860) 523-3775
Mailing address
263 FARMINGTON AVE, PROVIDER ENROLLMENT, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24331
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073642658
—
CT
Enumeration date
03/02/2007
Last updated
06/19/2012
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