Individual
SAMUEL M ROH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06032-1956
(860) 679-2000
Mailing address
115 EDGEWOOD AVE APT 70, NEW HAVEN, CT 06511-4585
(203) 815-0669
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
12884
CT
Other
Enumeration date
02/01/2020
Last updated
08/10/2020
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