Provider Demographics
NPI:1982774279
Name:TROSS, ROBERT BRUCE (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:BRUCE
Last Name:TROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:149 DURHAM ROAD
Mailing Address - Street 2:SUITE 25
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443
Mailing Address - Country:US
Mailing Address - Phone:203-318-3050
Mailing Address - Fax:203-318-3048
Practice Address - Street 1:149 DURHAM ROAD
Practice Address - Street 2:SUITE 25
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443
Practice Address - Country:US
Practice Address - Phone:203-318-3050
Practice Address - Fax:203-318-3048
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0226112086S0105X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
Not Answered2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
B83386Medicare UPIN