Individual
MR. NICHOLAS JOSEPH ROSAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
336 N MAIN ST STE A, WEST HARTFORD, CT 06117-2675
(860) 200-7701
Mailing address
336 N MAIN ST STE A, WEST HARTFORD, CT 06117-2675
(860) 200-7701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-04191
NC
363A00000X
Physician Assistant
Primary
5242
CT
363AM0700X
Medical Physician Assistant
MA053589
PA
363AS0400X
Surgical Physician Assistant
0010-04191
NC
Other
Enumeration date
09/12/2008
Last updated
02/09/2022
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