| NPI | 1225319445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSS WILLIAM PORTER President 860-749-3169 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: CT 032642) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2011-09-01 |