| NPI | 1265051809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WHITNEY AHNEMAN Chief Operating Officer 203-550-1062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |