| NPI | 1659777563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN IVETTE MARTELL Family Nurse Practitioner 860-922-2435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2014-11-05 |
| Last Update Date | 2014-11-14 |