Provider Demographics
NPI:1972591063
Name:ROSENFELD, LYNDA E (MD)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:E
Last Name:ROSENFELD
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 1:789 HOWARD AVE
Mailing Address - Street 2:DANA BUILDING, 3RD FLOOR
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1304
Mailing Address - Country:US
Mailing Address - Phone:203-785-4629
Mailing Address - Fax:203-785-3588
Practice Address - Street 1:789 HOWARD AVE
Practice Address - Street 2:DANA BUILDING, 3RD FLOOR
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1304
Practice Address - Country:US
Practice Address - Phone:203-785-4629
Practice Address - Fax:203-785-3588
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT021179207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001211796Medicaid
CT110001863Medicare ID - Type Unspecified
CT001211796Medicaid