| NPI | 1104192921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AYESHA AHMED Manager 860-655-1488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CT 048477) |
| Enumeration Date | 2012-03-26 |
| Last Update Date | 2022-07-11 |