Individual
KATIE ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
114 WOODLAND ST, DEPARTMENT OF SURGERY, HARTFORD, CT 06105-1208
(860) 714-5237
(860) 714-8097
Mailing address
114 WOODLAND ST, DEPARTMENT OF SURGERY, HARTFORD, CT 06105-1208
(860) 714-5237
(860) 714-8097
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
002468
CT
363AS0400X
Surgical Physician Assistant
Primary
002468
CT
Other
Enumeration date
09/30/2010
Last updated
11/25/2015
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