| NPI | 1194009860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE SCOTT HARRISON Manager 203-261-2348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: CT 001199) |
| Enumeration Date | 2011-09-29 |
| Last Update Date | 2011-09-29 |