| NPI | 1114115706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID V PENRY President 203-518-2124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care |
| 363LF0000X Nurse Practitioner, Family | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2016-06-01 |