| NPI | 1487905386 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN HEALY Owner 203-245-9317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CT 001235) |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2012-10-02 |