| NPI | 1427125558 |
|---|---|
| Doing Business As | SPORTMED |
| Entity Type | Organization |
| Authorized Contact | PETER LA ROY BERTACCHI Medical Director 203-359-2042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: CT 034033) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2008-01-23 |