Provider Demographics
NPI:1073650180
Name:CHAPLEAU, ROSANNA S (PA-C)
Entity Type:Individual
Prefix:
First Name:ROSANNA
Middle Name:S
Last Name:CHAPLEAU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-2100
Mailing Address - Country:US
Mailing Address - Phone:203-791-2221
Mailing Address - Fax:203-791-0682
Practice Address - Street 1:2 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-2100
Practice Address - Country:US
Practice Address - Phone:203-791-2221
Practice Address - Fax:203-791-0682
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001118363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant