Provider Demographics
NPI:1043892904
Name:ROSATI, KARLA MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:MARIE
Last Name:ROSATI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 PARK LANE RD STE A101
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-2445
Mailing Address - Country:US
Mailing Address - Phone:860-355-8190
Mailing Address - Fax:
Practice Address - Street 1:120 PARK LANE RD STE A101
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-2445
Practice Address - Country:US
Practice Address - Phone:860-355-8190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2023-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5288208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty