| NPI | 1023510179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE MARIE IENNACO Psychiatric Nurse Practitioner 203-285-5399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: CT 4459) |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2018-03-05 |