| NPI | 1477534089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE A RUDMAN Senior Vice President, CFO 860-612-6309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282E00000X (Licence: CT 03CD) |
| Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics |
| 261QD0000X Clinic/Center, Dental (Licence: CT 03CD) | |
| 261QD1600X Clinic/Center, Developmental Disabilities (Licence: CT 03CD) | |
| 261QR0400X Clinic/Center, Rehabilitation (Licence: CT 03CD) | |
| 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: CT 03CD) | |
| 281P00000X Chronic Disease Hospital | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2021-05-07 |