| NPI | 1295920015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA I LOPEZ Practice Manager 860-589-5238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CT 1896539000) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2007-09-14 |