| NPI | 1093974602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM A WOLLMAN Executive Director 860-533-2123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QE0800X Clinic/Center, Endoscopy |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2017-11-15 |