| NPI | 1104988609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS C MCKELL Chief Administrative Officer 860-524-4326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| 2086X0206X Surgery, Surgical Oncology | |
| 208800000X Urology | |
| 208C00000X Colon & Rectal Surgery | |
| 213E00000X Podiatrist | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 208200000X Plastic Surgery | |
| 2082S0105X Plastic Surgery, Surgery of the Hand | |
| 208600000X Surgery | |
| 2086S0105X Surgery, Surgery of the Hand | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2010-08-11 |