| NPI | 1245410406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA A REILLY Manager 203-597-0393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 19477) |
| Additional Taxonomies | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: CT 19477) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: CT 003751) | |
| Enumeration Date | 2007-11-05 |
| Last Update Date | 2015-05-21 |