| NPI | 1629263637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY M. BERTMAN Owner 860-437-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 028661) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 016287) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2007-09-12 |