| NPI | 1588957872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMED TELEB Owner 860-992-2214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine (Licence: CT 000829) |
| Enumeration Date | 2011-05-19 |
| Last Update Date | 2011-05-19 |