Healthcare Provider Details

I. General information

NPI: 1013607134
Provider Name (Legal Business Name): MARIA DEL PILAR ROSARIO LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2023
Last Update Date: 05/16/2023
Certification Date: 05/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 WADSWORTH ST STE 2
HARTFORD CT
06106-7108
US

IV. Provider business mailing address

45 WADSWORTH ST
HARTFORD CT
06106-7108
US

V. Phone/Fax

Practice location:
  • Phone: 860-524-1124
  • Fax: 860-692-1014
Mailing address:
  • Phone: 860-524-1124
  • Fax: 860-724-2539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number42743
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: