| NPI | 1619779907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANIA HOSSIN Manager 203-901-7242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2025-03-26 |
| Last Update Date | 2025-06-25 |