| NPI | 1225571565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY L FEDSK Financial Administrator 203-648-9182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 002614) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 006478) |
| Enumeration Date | 2016-11-18 |
| Last Update Date | 2016-11-18 |