| NPI | 1558715466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARAMUNI ANURA DESILVA Owner 203-535-0262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 06556) | |
| Enumeration Date | 2016-04-17 |
| Last Update Date | 2021-05-04 |