| NPI | 1639526890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL D BERGMAN Owner 203-671-1149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2024-02-08 |