| NPI | 1639734338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARIQUE PERERA CEO 203-321-5063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2019-05-14 |