Individual
IVAN M ROSAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2979 MAIN ST, BRIDGEPORT, CT 06606-4284
(203) 683-5100
Mailing address
1290 SILAS DEANE HWY, WETHERSFIELD, CT 06109-4337
(203) 962-3402
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6913
CT
363A00000X
Physician Assistant
—
—
Other
Enumeration date
07/29/2024
Last updated
01/29/2025
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