Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0105X | Surgery of the Hand | 022611 | CT |
N | 2086S0122X | Plastic and Reconstructive Surgery | 022611 | CT |
NPI | 1982774279 |
---|---|
Provider Name | Robert Bruce Tross |
First Address | Madison, CT 06443 |
Second Address | Madison, CT 06443 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B83386 | (02) |