Individual
CAROLYN ANN RODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIANS ASSISTANT
Contact information
Practice address
9 FARM SPRINGS RD, FARMINGTON, CT 06032-2576
(860) 243-4899
(860) 392-3571
Mailing address
1290 SILAS DEANE HWY, HHC-CVO, WETHERSFIELD, CT 06109-4337
(860) 972-5507
(860) 972-7040
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001360
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004224490
—
CT
01
—
290001360CT05
BLUE CROSS & BLUE SHIELD
CT
01
—
2V6845
HEALTHNET
CT
Enumeration date
11/27/2006
Last updated
07/30/2025
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