| NPI | 1619020153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA PENNEY Practice Administrator 860-496-9877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CT 039414) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: CT 493408001) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2019-05-20 |