| NPI | 1205409463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE J. PHILLIPS Medical Director/Owner 203-572-7491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2021-07-23 |
| Last Update Date | 2021-07-23 |