Provider Demographics
NPI:1275632994
Name:ARONSON, MARC DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:DAVID
Last Name:ARONSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-3656
Mailing Address - Country:US
Mailing Address - Phone:860-347-2366
Mailing Address - Fax:860-347-1525
Practice Address - Street 1:11 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-3656
Practice Address - Country:US
Practice Address - Phone:860-347-2366
Practice Address - Fax:860-347-1525
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0238792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC64969Medicare UPIN