Individual
MR. MISAEL RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1450 CHAPEL ST, FAMILY HEALTH CENTER PEDIATRIC CLINIC, NEW HAVEN, CT 06511-4405
(203) 789-3499
Mailing address
1450 CHAPEL ST, FAMILY HEALTH CENTER PEDIATRIC CLINIC, NEW HAVEN, CT 06511-4405
(203) 789-3499
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0006685
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004175031
—
CT
Enumeration date
06/06/2006
Last updated
10/18/2007
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