Individual
RALPH ROSENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
36 EAST MAIN STREET, AVON, CT 06001-3828
(860) 677-5533
(860) 678-1305
Mailing address
36 EAST MAIN STREET, AVON, CT 06001-3828
(860) 677-5533
(860) 678-1305
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
023114
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004245884
—
CT
01
—
010023114CT02
BC/BS
CT
01
—
050388
CONNECTICARE
CT
Enumeration date
08/29/2006
Last updated
07/12/2017
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