Provider Demographics
NPI:1093898421
Name:BARRY M ROSEN KRANZ MD PC
Entity Type:Organization
Organization Name:BARRY M ROSEN KRANZ MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROSENKRANZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-521-1920
Mailing Address - Street 1:10 NORTH MAIN STREET
Mailing Address - Street 2:SUITE 309
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107
Mailing Address - Country:US
Mailing Address - Phone:860-521-1920
Mailing Address - Fax:860-521-2129
Practice Address - Street 1:10 NORTH MAIN STREET
Practice Address - Street 2:SUITE 309
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107
Practice Address - Country:US
Practice Address - Phone:860-521-1920
Practice Address - Fax:860-521-2129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT145822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B83206Medicare UPIN