| NPI | 1477822690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL BEAUDRY Practice Administrator 203-327-1055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0200X Registered Nurse, Pediatrics (Licence: CT 001946) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CT 001903) |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2011-12-16 |