Individual
NINA P ROSSOMANDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
567 VAUXHALL STREET EXT, SUITE 317, WATERFORD, CT 06385-4330
(860) 444-6159
(860) 444-7111
Mailing address
567 VAUXHALL STREET EXT, SUITE 317, WATERFORD, CT 06385-4330
(860) 444-6159
(860) 444-7111
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
645
CT
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
645
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060000645CT03
ANTHEM BCBS OF CT
CT
01
—
072470
VALUE OPTIONS
—
01
—
176468
MANAGED HEALTH NETWORK
—
Enumeration date
01/13/2007
Last updated
09/11/2025
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