Provider Demographics
NPI:1710980149
Name:VENTI, ROZANN F (MD)
Entity Type:Individual
Prefix:DR
First Name:ROZANN
Middle Name:F
Last Name:VENTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:AMSTON
Mailing Address - State:CT
Mailing Address - Zip Code:06231-1403
Mailing Address - Country:US
Mailing Address - Phone:860-228-9463
Mailing Address - Fax:860-228-3766
Practice Address - Street 1:269 CHURCH ST
Practice Address - Street 2:
Practice Address - City:AMSTON
Practice Address - State:CT
Practice Address - Zip Code:06231-1403
Practice Address - Country:US
Practice Address - Phone:860-228-9463
Practice Address - Fax:860-228-3766
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT020521207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B38265Medicare UPIN
110008003Medicare ID - Type Unspecified