| NPI | 1174801898 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARI REBANE-MAZZOTTA Physician/Owner 860-343-0122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: CT 049437) |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2011-07-29 |