| NPI | 1417987595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN BAILEY Officer / AO 203-609-1168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MD A1385) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2025-10-15 |