| NPI | 1609892298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOWARD W. ROGERS Owner 860-859-2262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CT 038560) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 002932) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2008-08-18 |