| NPI | 1508876103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN PETER FUGAL Owner 203-878-5941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2023-03-07 |