| NPI | 1366497299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAHEEN AHMED Owner 203-238-3788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CT 033904) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 042588) |
| 207Q00000X Family Medicine (Licence: CT 046516) | |
| 208000000X Pediatrics (Licence: CT 031248) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 0033368) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 4217) | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2017-04-28 |