| NPI | 1205378163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURENCE I RADIN Presiden 860-443-1891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 003463) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2017-01-03 |