| NPI | 1043520604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA M CIVARDI Owner 860-383-2024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CT 004438) |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2010-10-18 |