| NPI | 1396538922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY PRENDERGAST Billing Manager 203-915-9712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 363LC0200X Nurse Practitioner, Critical Care Medicine |
| Enumeration Date | 2025-05-27 |
| Last Update Date | 2025-05-27 |