| NPI | 1558050484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIC'COLE LAMBERT-TALHAOUI Nurse Practitioner 860-248-9007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-05-05 |
| Last Update Date | 2023-05-05 |