| NPI | 1336189646 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAHEEN AHMED Owner 860-229-1113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 046516) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 042588) |
| 207R00000X Internal Medicine (Licence: CT 015249) | |
| 208000000X Pediatrics (Licence: CT 033904) | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 0033368) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 4217) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2016-04-06 |