Most Relevant Information
Provider Data
| NPI Number: | 1003592205 |
| Provider Name: | RYAN CHRISTIAN ROGERS PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | 1192561 |
Most Important Dates
| Enumeration Date: | 06/23/2023 |
| Last Updated: | 06/23/2023 |
Provider Practice Location
20 YORK ST
NEW HAVEN
CT
065103220
Practice Location Phone/Fax
| Phone: | 2037852618 |
| Fax: | 2037372221 |
Provider Mailing Location
4 COURTNEY LN
SOUTHAMPTON
MA
010739647
Provider Mailing Phone/Fax
| Phone: | 4136955087 |
| Fax: |