Provider Demographics
NPI:1174655161
Name:ROSANNE DEMANSKI
Entity type:Organization
Organization Name:ROSANNE DEMANSKI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NATUROPATHIC PHYSICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:860-561-9766
Mailing Address - Street 1:998 FARMINGTON AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2162
Mailing Address - Country:US
Mailing Address - Phone:860-561-9766
Mailing Address - Fax:
Practice Address - Street 1:998 FARMINGTON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2162
Practice Address - Country:US
Practice Address - Phone:860-561-9766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000133302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization