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General NPI Number Information
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NPI Number | 1083602874
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Entity Type | Individual
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Provider Name | ROSAIRE W BISSON PA
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Gender | Male
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 10/15/2007
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Provider Practice Location Address
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Address Line | 44 MAIN ST STE 200
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City | RICHFORD
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State | VT
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Zip | 05476-1141
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Country | US
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Telephone | 802-255-5500
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Fax | 802-255-5509
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Provider Business Mailing Address
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Address Line | 655 HOLY CROSS RD
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City | COLCHESTER
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State | VT
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Zip | 05446-9719
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Country | US
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Telephone | 802-848-3829
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Fax | 802-848-3829
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0550030282
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License Number State | VT
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