Healthcare Provider Details

I. General information

NPI: 1912234907
Provider Name (Legal Business Name): URGENT CARE OF BROOKFIELD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2009
Last Update Date: 11/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 OLD ROUTE 7
BROOKFIELD CT
06804-1714
US

IV. Provider business mailing address

31 OLD ROUTE 7
BROOKFIELD CT
06804-1714
US

V. Phone/Fax

Practice location:
  • Phone: 203-262-1911
  • Fax: 203-262-9434
Mailing address:
  • Phone: 203-262-1911
  • Fax: 203-262-9434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: R. ROBERT ROHATSCH
Title or Position: OWNER/PHYSICAN
Credential: MD
Phone: 203-262-1911