| NPI | 1003841065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANITA GREEN Office Manager 860-545-5061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 41802) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2020-08-22 |