| NPI | 1033701586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC ADDO Authorized Official 860-262-4489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207N00000X Dermatology | |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 207RH0003X Internal Medicine, Hematology & Oncology | |
| 207RI0200X Internal Medicine, Infectious Disease | |
| 207RN0300X Internal Medicine, Nephrology | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| Enumeration Date | 2021-02-05 |
| Last Update Date | 2021-02-05 |