| NPI | 1568805059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT M KALLOR Do / Owner 860-286-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: CT 042001) |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2013-05-06 |