NPI | 1023356979 |
---|---|
Entity Type | Organization |
Authorized Contact | RICHARD F COMSHAW Owner 860-736-4139 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/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 |