Individual
ROSE M IANNINO-RENZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
687 CAMPBELL AVE, WEST HAVEN MEDICAL GROUP, WEST HAVEN, CT 06516-3774
(203) 415-9093
Mailing address
687 CAMPBELL AVE, WEST HAVEN MEDICAL GROUP, WEST HAVEN, CT 06516-3774
(203) 415-9093
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
001585
CT
Other
Enumeration date
03/05/2008
Last updated
07/08/2013
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