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Individual

DR. DOMINICK F ROTO II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO FAAFP

Contact information

Practice address
145 POMFRET ST, PUTNAM, CT 06260
(860) 928-5248
(860) 928-5286
Mailing address
145 POMFRET ST, PUTNAM, CT 06260-1803
(860) 928-5248
(860) 928-5286

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
000328
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001003285
CT
01
040000328CJ01
BCBS
CT
01
2962295
AETNA
Enumeration date
11/03/2006
Last updated
04/02/2015
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