Individual
RYAN L ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
415 KILLINGWORTH RD, HIGGANUM, CT 06441-4370
(860) 345-8535
(860) 345-8678
Mailing address
500 ALBANY AVE, HARTFORD, CT 06120-2508
(860) 249-9625
(860) 808-1580
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
994473
CT
163W00000X
Registered Nurse
RN2284731
MA
363L00000X
Nurse Practitioner
Primary
5832
CT
363LF0000X
Family Nurse Practitioner
5832
CT
Other
Enumeration date
02/24/2014
Last updated
10/17/2019
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