| NPI | 1154136380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN BAILEY Authorized Official 203-609-1168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2025-02-13 |
| Last Update Date | 2025-06-12 |