| NPI | 1376906354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN BAILEY Officer/Authorized Official 203-609-1168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2023-10-20 |