| NPI | 1114120698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSEMARY STEPHENSON Office Manager 860-443-1891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 003504) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-08-22 |