Provider Demographics
NPI:1720071178
Name:ROSSI, ARNOLD J (MD)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:J
Last Name:ROSSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 RETREAT AVE
Mailing Address - Street 2:#705
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-2528
Mailing Address - Country:US
Mailing Address - Phone:860-278-0070
Mailing Address - Fax:860-522-6081
Practice Address - Street 1:100 RETREAT AVE
Practice Address - Street 2:#705
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-2528
Practice Address - Country:US
Practice Address - Phone:860-278-0070
Practice Address - Fax:860-522-6081
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306357207T00000X
CT15262207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001196450Medicaid
CT140000143Medicare ID - Type Unspecified
CT001196450Medicaid