| NPI | 1457604001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROCCO ORLANDO Medical Director 860-263-4155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 208800000X Urology |
| 213E00000X Podiatrist | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2017-12-18 |