| NPI | 1053581868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER G JOSE Physician 203-662-9602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CT 037301) |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2026-06-08 |