Organization Active NPI

Ralph Rosenberg MD

  • Internal Medicine Physician
  • Avon, CT
National Provider Identifier
1871774885
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
023114 Issued in CT
Legal business name
RALPH ROSENBERG MD
Practice address
36 E Main St
Avon, CT 06001-3801
Phone
(860) 677-5533
Fax
(860) 678-1305
NPI assigned
Nov 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ralph Rosenberg, MD
Title
Owner/Operator
Phone
(860) 677-5533

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 023114 CT Primary

Addresses

Primary practice location

36 E Main St
Avon, CT 06001-3801

Mailing address

36 E Main St
Avon, CT 06001-3801
Phone (860) 677-5533

Other identifiers 1

IdentifierTypeStateIssuer
004245884MedicaidCT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1871774885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 E MAIN ST",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013801",
            "telephone_number": "860-677-5533",
            "fax_number": "860-678-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 E MAIN ST",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013801",
            "telephone_number": "860-677-5533",
            "fax_number": "860-678-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RALPH ROSENBERG MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-19",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "ROSENBERG",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "860-677-5533",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "023114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004245884",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.