| NPI | 1023356979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD F COMSHAW Owner 860-736-4139 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CT 001702) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: CT 001702) |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2023-02-10 |