| NPI | 1306488762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ALLEN Partner 203-870-1796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 163WC1500X Registered Nurse, Community Health |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2022-01-05 |