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General NPI Number Information
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NPI Number | 1457388183
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Entity Type | Individual
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Provider Name | LAUREEN FORGIONE-RUBINO MD
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Gender | Female
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 06/23/2021
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Provider Practice Location Address
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Address Line | 945 MAIN STREET SUITE #105
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City | MANCHESTER
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State | CT
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Zip | 06040
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Country | US
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Telephone | 860-645-1232
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Fax | 860-647-0438
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Provider Business Mailing Address
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Address Line | 945 MAIN STREET SUITE #105
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City | MANCHESTER
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State | CT
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Zip | 06040
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Country | US
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Telephone | 860-645-1232
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Fax | 860-647-0438
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 033061
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License Number State | CT
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