Healthcare Provider Details

I. General information

NPI: 1508773839
Provider Name (Legal Business Name): ROSSANA B. RODRIGUEZ MATEO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 2247
NORWALK CT
06852-2247
US

IV. Provider business mailing address

PO BOX 2247
NORWALK CT
06852-2247
US

V. Phone/Fax

Practice location:
  • Phone: 203-644-6809
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberCT091316085E
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: