Provider Demographics
NPI:1477793529
Name:ROSEWATER, IRINA G (MD)
Entity Type:Individual
Prefix:DR
First Name:IRINA
Middle Name:G
Last Name:ROSEWATER
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Gender:F
Credentials:MD
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Mailing Address - Street 1:200 ORCHARD ST
Mailing Address - Street 2:STE 207
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5363
Mailing Address - Country:US
Mailing Address - Phone:203-776-4444
Mailing Address - Fax:203-776-4441
Practice Address - Street 1:200 ORCHARD ST
Practice Address - Street 2:STE 207
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-3206
Practice Address - Country:US
Practice Address - Phone:203-776-4444
Practice Address - Fax:203-776-4441
Is Sole Proprietor?:No
Enumeration Date:2009-03-03
Last Update Date:2009-11-16
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Provider Licenses
StateLicense IDTaxonomies
CT044226207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT400003457Medicare PIN