| NPI | 1093750150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA T ELLISON Executive Director 203-288-2555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: CT 0266) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2020-08-22 |