| NPI | 1396120168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD STAUNTON Executive Director 203-252-5399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2025-03-26 |