Healthcare Provider Details

I. General information

NPI: 1700453685
Provider Name (Legal Business Name): ROSEMOND Y. ANKRAH FNP/DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2021
Last Update Date: 06/08/2021
Certification Date: 06/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 ELLA T GRASSO BLVD
NEW HAVEN CT
06519-5516
US

IV. Provider business mailing address

60 SENECA RD
NEW HAVEN CT
06515-1535
US

V. Phone/Fax

Practice location:
  • Phone: 203-349-9400
  • Fax:
Mailing address:
  • Phone: 203-500-3509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF06210627
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: