Healthcare Provider Details

I. General information

NPI: 1982774279
Provider Name (Legal Business Name): ROBERT BRUCE TROSS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 DURHAM ROAD SUITE 25
MADISON CT
06443
US

IV. Provider business mailing address

149 DURHAM ROAD SUITE 25
MADISON CT
06443
US

V. Phone/Fax

Practice location:
  • Phone: 203-318-3050
  • Fax: 203-318-3048
Mailing address:
  • Phone: 203-318-3050
  • Fax: 203-318-3048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number022611
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number022611
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: