Provider Demographics
NPI:1548562382
Name:RONNI G STEIN M.D., P.C.
Entity Type:Organization
Organization Name:RONNI G STEIN M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RONNI
Authorized Official - Middle Name:G
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:860-523-4225
Mailing Address - Street 1:125 LASALLE RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2322
Mailing Address - Country:US
Mailing Address - Phone:860-523-4225
Mailing Address - Fax:860-523-4225
Practice Address - Street 1:125 LASALLE RD
Practice Address - Street 2:SUITE 310
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2322
Practice Address - Country:US
Practice Address - Phone:860-523-4225
Practice Address - Fax:860-523-4225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0230692084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT080000131Medicare PIN