| NPI | 1174711188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN AUGUSTINE FARENS President 203-926-1206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: CT 028528) |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2011-03-21 |