| NPI | 1275846453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNEE MOODY Credentialing Coordinator 860-289-3375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2010-12-21 |