| NPI | 1336388453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER PICHAY Vice President/Treasurer 860-966-0937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MA 229762) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: MA 229765) |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2009-05-01 |