Provider Demographics
NPI:1629335062
Name:AROESTY, RENA LUGER (MD)
Entity Type:Individual
Prefix:
First Name:RENA
Middle Name:LUGER
Last Name:AROESTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RENA
Other - Middle Name:M
Other - Last Name:LUGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31 MOHEGAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117
Mailing Address - Country:US
Mailing Address - Phone:860-655-0111
Mailing Address - Fax:
Practice Address - Street 1:816 BROAD STREET
Practice Address - Street 2:SUITE 16 BLDG. 1
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450
Practice Address - Country:US
Practice Address - Phone:203-238-1256
Practice Address - Fax:203-634-3203
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT054156208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics