Healthcare Provider Details

I. General information

NPI: 1174655161
Provider Name (Legal Business Name): ROSANNE DEMANSKI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

998 FARMINGTON AVE SUITE 200
WEST HARTFORD CT
06107-2162
US

IV. Provider business mailing address

998 FARMINGTON AVE SUITE 200
WEST HARTFORD CT
06107-2162
US

V. Phone/Fax

Practice location:
  • Phone: 860-561-9766
  • Fax:
Mailing address:
  • Phone: 860-561-9766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number000133
License Number StateCT

VIII. Authorized Official

Name: MS. ROSANNE DEMANSKI
Title or Position: NATUROPATHIC PHYSICIAN
Credential: N.D.
Phone: 860-561-9766