| NPI | 1548917594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MARIA SOUSA JEROME Nurse Practitioner 860-375-2227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-03-09 |
| Last Update Date | 2023-04-28 |