Healthcare Provider Details

I. General information

NPI: 1932632361
Provider Name (Legal Business Name): MIRUNA CARNARU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 07/07/2021
Certification Date: 07/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 SEYMOUR ST STE 206
HARTFORD CT
06106-5521
US

IV. Provider business mailing address

1290 SILAS DEANE HWY
WETHERSFIELD CT
06109-4337
US

V. Phone/Fax

Practice location:
  • Phone: 860-524-2610
  • Fax: 860-524-2615
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number68099
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: