| NPI | 1508241076 |
|---|---|
| Doing Business As | STATIONHOUSE PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | SUSAN MELITO Office Manager 203-375-9350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO 070195) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2015-07-27 |