Healthcare Provider Details

I. General information

NPI: 1831471879
Provider Name (Legal Business Name): R & R MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2011
Last Update Date: 10/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 WOLCOTT RD
WOLCOTT CT
06716-2673
US

IV. Provider business mailing address

503 WOLCOTT RD
WOLCOTT CT
06716-2673
US

V. Phone/Fax

Practice location:
  • Phone: 860-346-4484
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number024628
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number04271
License Number StateCT

VIII. Authorized Official

Name: RONALD B ROBBINS
Title or Position: MD
Credential:
Phone: 860-346-4484