| NPI | 1477766202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY M BARCZAK Owner 860-444-6711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CT 024666) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: CT 000368) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2007-09-12 |