| NPI | 1093014748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY E. AMATO Practice Manager 860-673-3737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 002626) |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2011-11-15 |