| NPI | 1407374481 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE GIGLIO Practice Manager 860-676-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: CT 040694) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: CT 040694) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2023-03-07 |