| NPI | 1053787564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MARTIN Vice President Finance & Treasurer 860-358-6140 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology |
| 2086S0129X Surgery, Vascular Surgery | |
| 2086X0206X Surgery, Surgical Oncology | |
| 208C00000X Colon & Rectal Surgery | |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2018-03-15 |