| NPI | 1386972693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA KANE V Ice President 860-442-0711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RC0000X Internal Medicine, Cardiovascular Disease | |
| 208600000X Surgery | |
| 208100000X Physical Medicine & Rehabilitation | |
| 207T00000X Neurological Surgery | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 106H00000X Marriage & Family Therapist | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2009-11-24 |
| Last Update Date | 2013-05-08 |