Individual
BRADLEY L. ROSENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
333 KENNEDY DR, SUITE L-104, TORRINGTON, CT 06790-3060
(860) 496-4043
(860) 496-4046
Mailing address
333 KENNEDY DR, SUITE L-104, TORRINGTON, CT 06790-3060
(860) 496-4043
(860) 496-4046
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
033543
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010033543CT01
BLUE CROSS
—
05
—
1335430
—
CT
01
—
2639112
AETNA
CT
01
—
2V0428
HEALTH NET OF CT
CT
01
—
335430
CONNECTICARE
CT
Enumeration date
07/17/2006
Last updated
07/08/2007
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