| NPI | 1063532596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS CEBALLOS Director 203-234-9317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CT pending) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2007-07-13 |