| NPI | 1003937988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRASAD SRINIVASAN President 860-246-7273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: CT 022206) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 000644) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 003860) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-10-15 |