| NPI | 1225430499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD C LYON Executive Director 203-845-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine |
| 363AS0400X Physician Assistant Surgical | |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2015-12-15 |