CAROLYN ANN RODERICK


Address: 170 Grandview Ave, Waterbury, CT 06708-2525
Phone: 2037593666

CAROLYN ANN RODERICK (NPI# 1548336258) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1548336258
Entity Type Individual
Full Name CAROLYN ANN RODERICK
Other Name CAROLYN ANN HEWKO
Credential PHYSICIANS ASSISTANT
Practice Address 170 Grandview Ave
Waterbury
CT 06708-2525
Practice Telephone 2037593666
Practice Fax Number 2037593671
Mailing Telephone 2037593666
Mailing Fax Number 2037593671
Enumeration Date 2006-11-27
Last Update Date 2017-01-27
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant 001360 CT Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
CT 004224490 05
CT BLUE CROSS & BLUE SHIELD 290001360CT05 01
CT HEALTHNET 2V6845 01

Office Location

Street Address 170 GRANDVIEW AVE
City WATERBURY
State CT
Zip Code 06708-2525

Providers in the same location

NPI Name Taxonomy Address Enumeration
1710904404 Ann Lorraine Hume Internal Medicine 170 Grandview Ave, Waterbury, CT 06708-2525 2006-07-17
1487033858 Michelle Marie King Registered Nurse 170 Grandview Ave, Waterbury, CT 06708-2525 2015-05-19
1669767059 Jameel Uddeen Internal Medicine 170 Grandview Ave, Waterbury, CT 06708-2525 2011-06-14
1912296419 Jennifer Elizabeth Ouellette Nurse Practitioner 170 Grandview Ave, Waterbury, CT 06708-2525 2011-04-05
1386951747 Vanessa Yap Internal Medicine 170 Grandview Ave, Waterbury, CT 06708-2525 2010-09-08
1508182965 Sheila Jane Tan Zanoria Internal Medicine 170 Grandview Ave, Waterbury, CT 06708 2010-04-09
1053599902 Ferdinando Urbano Internal Medicine 170 Grandview Ave, Waterbury, CT 06708 2008-02-02
1669501532 Waterbury Pulmonary Associates Internal Medicine 170 Grandview Ave, Waterbury, CT 06708-2513 2007-03-05
1770695140 Sandra J Dock Physician Assistant 170 Grandview Ave, Waterbury, CT 06708-2525 2006-08-31

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1952864787 Sidhant Singh Student in an Organized Health Care Education/Training Program Chase Outpatient Center,160 Robbins Street, Waterbury, CT 06708 2019-04-09
1023574753 Santa Maria & Schneider D.m.d Waterbury LLC Dentist 276 Highland Ave., Waterbury, CT 06708 2019-02-19
1548766959 Caroline Johnssen Student in an Organized Health Care Education/Training Program Chase Outpatient Center, 160 Robbins Street, Waterbury, CT 06708 2018-04-04
1992209530 Valley Wellness Consulting Group LLC Social Worker 969 W Main Street, Suite 3e, Waterbury, CT 06708 2018-03-20
1306346457 C&s Family Dental Waterbury, LLC Dentist 1630 Watertown Ave, Waterbury, CT 06708 2018-02-15
1447759865 Inurse Homecare, LLC. Home Health 140 Fulkerson Drive Unit 2c, Waterbury, CT 06708 2018-02-12
1619423977 Robert Girard II Counselor 969 West Main Street, Suite 1 D, Waterbury, CT 06708 2016-08-28
1457734360 Alternatives, Inc. Intermediate Care Facility, Mentally Retarded 148 Highview St, Waterbury, CT 06708 2015-07-09
1407266901 Maria Munoz Obstetrics & Gynecology 140 Grandview Ave Ste 202, Waterbury, CT 06708 2014-05-06
1922420330 Danielle Moraes Social Worker 276 Highland Av 2nd Fl North, Waterbury, CT 06708 2014-01-21
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1609481639 Gresi Kello Physician Assistant 506 Frost Rd, Waterbury, CT 06705-2304 2020-09-15
1801446554 George Ahyia Osae Jr. Physician Assistant 67 Buckland Dr, Waterbury, CT 06704 2019-09-16
1912495797 Jennie Webb Physician Assistant 2247 E Main St Ste 103, Waterbury, CT 06705 2018-04-26
1003188814 Jodi Lasky Physician Assistant 26 Westport Dr, Waterbury, CT 06706-2854 2012-02-09
1255668968 Michele C Pierce Physician Assistant 60 Westwood Ave Ste 314, Waterbury, CT 06708-2460 2009-11-17
1700035615 Marissa L Stankus Physician Assistant 171 Grandview Ave Ste 201, Waterbury, CT 06708-2520 2008-09-16
1588699557 Adriane Guerin Physician Assistant 179 Roseland Ave, Waterbury, CT 06710 2006-07-11
1407826522 Deanna Michaud Physician Assistant 2247 E Main St, Suite 103, Waterbury, CT 06705 2006-01-23
1891777918 Alan Robert Houle Physician Assistant 1211 W Main St, Waterbury, CT 06708-3106 2005-11-15
1750389375 Huma Tariq Khaliq Physician Assistant 232 N Elm St, Waterbury, CT 06702-1516 2005-07-08
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Competitor

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City WATERBURY
Zip Code 06708

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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