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General NPI Number Information
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NPI Number | 1093067019
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Entity Type | Individual
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Provider Name | GWENN ROSENBERG ND
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Gender | Female
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Dates
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Enumeration Date | 10/15/2012
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Last Update Date | 11/27/2019
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Provider Practice Location Address
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Address Line | 154 HEMPSTEAD ST FIRST FLOOR
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City | NEW LONDON
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State | CT
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Zip | 06320
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Country | US
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Telephone | 860-650-1030
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Fax | 855-869-4891
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Provider Business Mailing Address
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Address Line | 16 RIVERVIEW PL
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City | QUAKER HILL
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State | CT
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Zip | 06375
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Country | US
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Telephone | 503-758-1878
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Fax | 855-869-4891
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 000486
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License Number State | CT
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