| NPI | 1285116707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BRADWAY Director Information Systems 203-568-7466 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CT 0353) |
| Enumeration Date | 2018-08-31 |
| Last Update Date | 2018-08-31 |