| NPI | 1639660194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH MADELINE BIRD Medical Director 860-532-0525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CT 53136) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2018-08-17 |