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NPI Code Detail

MEDICARE: DR. GLEN ROSENFELD MD

MEDICARE: DR. GLEN ROSENFELD MD
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
1174400000XSpecialist041323CT
2207L00000XAnesthesiology Physician41323CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598753394
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GLEN ROSENFELD MD
Provider Business Mailing Address
First Line : 831 BOSTON POST RD
Second Line : SUITE 203
City : MILFORD
State : CT
Zip : 06460-3536
Country : US
Telephone Number : 203-783-1831
Fax Number :
Provider Business Practice Location Address
First Line : 41 BREWSTER RD
Second Line :
City : BRISTOL
State : CT
Zip : 06010-5161
Country : US
Telephone Number : 860-845-8570
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2005
Last Update Date : 10/02/2013

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Directions to “ DR. GLEN ROSENFELD MD” Practice Location

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