| NPI | 1639473879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA R CAPONE Credentialing/Hr 203-752-3181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 213E00000X Podiatrist |
| 207QS0010X Family Medicine, Sports Medicine | |
| 363A00000X Physician Assistant | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2013-09-09 |