| NPI | 1558937748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BRADWAY Director Of Information Systems 203-568-7466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2021-05-28 |
| Last Update Date | 2021-05-28 |