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1992005599
PHILIP M ROACH
NEW BRITAIN, CT
NPI
1992005599
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CT 002469)
Enumeration Date
2010-10-28
Last Update Date
2015-10-05
Business Address
-- PHILIP M ROACH
100 GRAND ST
NEW BRITAIN, CT 06052-2016
Phone number: 860-224-5011
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Mailing Address
-- PHILIP M ROACH
PO BOX 1090
WINDSOR, CT 06095-6190
Phone number: 203-709-3117
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