| NPI | 1205018470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID J DOMENICHINI Owner/Physician 860-561-1007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: CT 032306) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 032306) |
| 363L00000X Nurse Practitioner (Licence: CT 032306) | |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2024-07-31 |