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NPI Code Detail

MEDICARE: DR. JONATHAN BRUCE STOLZENBERG M.D.

MEDICARE:  DR. JONATHAN BRUCE STOLZENBERG  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician021676CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1021676OTHERCTLICENSE TO PRACTICE MEDICINE

General Provider Information

NPI Number : 1386892354
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN BRUCE STOLZENBERG M.D.
Provider Business Mailing Address
First Line : 32 ARLINGTON RD
Second Line :
City : WEST HARTFORD
State : CT
Zip : 06107-1603
Country : US
Telephone Number : 860-521-5685
Fax Number :
Provider Business Practice Location Address
First Line : 32 ARLINGTON RD
Second Line :
City : WEST HARTFORD
State : CT
Zip : 06107-1603
Country : US
Telephone Number : 860-521-5685
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2008
Last Update Date : 03/07/2023

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Directions to “ DR. JONATHAN BRUCE STOLZENBERG M.D.” Practice Location

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