NPI | 1114269032 |
---|---|
Entity Type | Organization |
Authorized Contact | DOMENICK JOHN MASIELLO Owner 203-826-3582 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 000278) |
Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CT 000278) |
Enumeration Date | 2013-03-18 |
Last Update Date | 2013-03-18 |