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NPI Code Detail

MEDICARE: ANDREW JOSEPH RODICAN PA

MEDICARE: ANDREW JOSEPH RODICAN PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant000473CT

General Provider Information

NPI Number : 1922098383
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW JOSEPH RODICAN PA
Provider Business Mailing Address
First Line : 306 FIELD POINT ROAD
Second Line :
City : BRANFORD
State : CT
Zip : 06405
Country : US
Telephone Number : 203-208-0902
Fax Number : 203-468-9661
Provider Business Practice Location Address
First Line : 52 WASHINGTON AVE STE 4
Second Line : FAMILY PRACTICE AND INTERNAL MEDICINE
City : NORTH HAVEN
State : CT
Zip : 06473-1724
Country : US
Telephone Number : 203-672-2800
Fax Number : 203-672-2801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2005
Last Update Date : 07/29/2014

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Directions to “ ANDREW JOSEPH RODICAN PA” Practice Location

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