| NPI | 1407255847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENIS BOUBOULIS Medical Director 203-309-5399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| 332900000X Non-Pharmacy Dispensing Site | |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2015-07-14 |