Provider Demographics
NPI:1689419210
Name:VU, ROSEMARY (PA-C)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:VU
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 1:30 HAZEL ST STE 201
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06604-7752
Mailing Address - Country:US
Mailing Address - Phone:203-576-2400
Mailing Address - Fax:
Practice Address - Street 1:30 HAZEL ST STE 201
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06604-7752
Practice Address - Country:US
Practice Address - Phone:203-576-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant