| NPI | 1104978063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUNDARAMURTHY BALACHANDRAN Business Chief 860-928-6044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 037442) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2016-09-16 |