| 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 |