Healthcare Provider Details

I. General information

NPI: 1467659078
Provider Name (Legal Business Name): JOANNA ROTHSTEIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOANNA KOENIGSBERG MD

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 09/15/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 WASHINGTON ST
HARTFORD CT
06106-3322
US

IV. Provider business mailing address

282 WASHINGTON ST CCMC - DEPT OF ANESTHESIOLOGY
HARTFORD CT
06106
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-9520
  • Fax:
Mailing address:
  • Phone: 860-545-9899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number259965
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number74283
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: