Provider Demographics
NPI:1609062603
Name:ROSSI, CARRIE ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:ROSSI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:ANN
Other - Last Name:LOOMIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:2408 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3209
Mailing Address - Country:US
Mailing Address - Phone:203-626-0160
Mailing Address - Fax:203-294-6734
Practice Address - Street 1:888 WHITE PLAINS RD STE 106
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4552
Practice Address - Country:US
Practice Address - Phone:203-268-2882
Practice Address - Fax:203-452-3099
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001968363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant