Individual
GHOLAMREZA SADEGHIPOUR ROODSARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
56 FRANKLIN ST, WATERBURY, CT 06706-1253
(203) 709-6000
Mailing address
450 CLARKSON AVE, BOX 1228, BROOKLYN, NY 11203-2098
(646) 591-8615
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
57036
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/02/2014
Last updated
11/10/2021
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