Provider Demographics
NPI:1861537086
Name:STEIN, RONNI G (MD)
Entity type:Individual
Prefix:
First Name:RONNI
Middle Name:G
Last Name:STEIN
Suffix:
Gender:F
Credentials:MD
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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
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
Practice Address - Country:US
Practice Address - Phone:860-523-4225
Practice Address - Fax:860-523-4225
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0230692084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1230697Medicaid
CT010023069CT04OtherBLUE CROSS