| NPI | 1588538417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH YAMILE MARCELLUS Director 860-884-6285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2025-10-02 |
| Last Update Date | 2025-10-02 |