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General NPI Number Information
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NPI Number | 1093244576
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Entity Type | Organization
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Legal Business Name | INFINITY HEALTH LLC
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 06/08/2017
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Provider Practice Location Address
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Address Line | 120 EAST AVE
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City | NORWALK
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State | CT
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Zip | 06851-5703
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Country | US
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Telephone | 203-853-0880
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Fax |
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Provider Business Mailing Address
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Address Line | 120 EAST AVE
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City | NORWALK
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State | CT
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Zip | 06851-5703
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALAN B ROSENTHAL
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Credential | DMD
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Telephone | 203-853-0880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 600716
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License Number State | CT
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