| NPI | 1255950044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKI MALDEN Vice President / Regional Operation 203-567-5243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2020-04-11 |
| Last Update Date | 2021-10-15 |