NPI | 1033376330 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN BIESTEK Owner 203-235-4462 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CT 000994) |
Enumeration Date | 2008-05-22 |
Last Update Date | 2008-05-22 |