Provider Demographics
NPI:1205860129
Name:ROHRIG, CAROLYN (CRNA)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:ROHRIG
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:
Other - Last Name:BYSTRIANYK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:7365 MAIN ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-1300
Mailing Address - Country:US
Mailing Address - Phone:203-384-3174
Mailing Address - Fax:
Practice Address - Street 1:267 GRANT ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-2805
Practice Address - Country:US
Practice Address - Phone:203-384-3072
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000705367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT430000860Medicare ID - Type Unspecified