Provider Demographics
NPI:1467687079
Name:ROSENBERGER, LISA DENISE (ND, MSOM, LAC)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:DENISE
Last Name:ROSENBERGER
Suffix:
Gender:F
Credentials:ND, MSOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 MONTOWESE ST
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3993
Mailing Address - Country:US
Mailing Address - Phone:203-915-9125
Mailing Address - Fax:203-777-7918
Practice Address - Street 1:217 MONTOWESE ST
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3993
Practice Address - Country:US
Practice Address - Phone:203-915-9125
Practice Address - Fax:203-643-4340
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000502171100000X
OR1642175F00000X
CT000432175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist