Individual
ROXANNE IRANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
80 SEYMOUR STREET, HARTFORD HOSPITAL MEDICINE ICU, HARTFORD, CT 06102-5307
(860) 545-2085
Mailing address
PO BOX 415933, HARTFORD HOSPITAL PROFESSIONAL SERVICES, BOSTON, MA 02241-5933
(860) 545-7602
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002739
CT
363AM0700X
Medical Physician Assistant
Primary
002739
CT
363AS0400X
Surgical Physician Assistant
002739
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003027307
—
CT
Enumeration date
04/13/2012
Last updated
05/14/2013
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