| NPI | 1437914959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE JEAN RAVECH Chief Managed Care Officer 860-305-6640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) |
| Additional Taxonomies | 261QG0250X Clinic/Center, Genetics |
| Enumeration Date | 2024-02-14 |
| Last Update Date | 2025-04-24 |