| NPI | 1548784556 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN BAILEY Officer/Authorized Official 203-609-1168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NH 767136) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2023-08-11 |