| NPI | 1649388786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEY MONTGOMERY FERNOW Owner Physician 203-204-1068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 044163) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2015-07-01 |