| NPI | 1356403323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA MARTINEZ Credentialing Coordinator 860-350-7685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 363AM0700X Physician Assistant, Medical | |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2025-09-15 |