| NPI | 1376957894 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | CIMMARON MERRITT Compliance Officer 203-667-3192 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CT 044806) | 
| Enumeration Date | 2014-06-12 | 
| Last Update Date | 2014-06-12 |