Provider Demographics
NPI:1093346793
Name:ROSENKRANTZ, STUART
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:
Last Name:ROSENKRANTZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 ELM ST
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-3808
Mailing Address - Country:US
Mailing Address - Phone:203-777-1234
Mailing Address - Fax:
Practice Address - Street 1:65 ELM ST
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-3808
Practice Address - Country:US
Practice Address - Phone:203-777-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-31
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide