Rosina I Bandanza, MD
Individual provider Active NPI Psychiatry Physician · Waterbury, CT
NPI 1114085461 · NPPES record last updated Mar 18, 2015
Key facts
- NPI
- 1114085461
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 033886 (CT)
- Practice address
- 95 Thomaston Ave
Western Connecticut Menatl Health Network
Waterbury, CT 06702-1007 - Phone
- (203) 805-5300
- Fax
- (203) 805-5310
- NPI assigned
- Dec 5, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040527001062 | CT | Practitioner - Psychiatry | 0547241218 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 033886 | CT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| State of Connecticut | Current |
Accepting new patients |
Locations
450 Columbus Blvd
Ste 1001
Hartford, CT 06103
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 033886 | CT | Yes |
Addresses
Primary practice location
95 Thomaston Ave
Western Connecticut Menatl Health Network
Waterbury, CT 06702-1007
Mailing address
95 Thomaston Ave
Waterbury, CT 06702-1007
Phone (203) 805-5300
Other providers in Waterbury, CT
- Matthew L Balanda
- John George Baldelli Jr.
- Michael Hugh Balfour
- Sehrish Sarwar Baloch
- Steven Michael Baltrush
- Vijitha Bandla
- Jessica Lynn Banning
- Vaishali Bansilal
- Nancy W Baranowski
- Ronald Matthew Barbieri
All providers in Waterbury, CT · Psychiatry Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.