| NPI | 1528561800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN PAUL JESKE Owner 203-518-5232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2024-01-14 |