| NPI | 1386931277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANELLE CONTOIS Medical Biller 203-757-9336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0602X Otolaryngology Otolaryngic Allergy (Licence: CT 12669) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: CT 000352) |
| 363AM0700X Physician Assistant Medical (Licence: CT 1139) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2011-06-30 |