| NPI | 1407498603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANOJ WADHWANI Authorized Official 203-260-7972 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2019-10-09 |