| NPI | 1457636383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUNIL SAXENA Medical Director 203-612-7511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: CT 043723) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: CT 3117) |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2012-01-30 |