| NPI | 1659793040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN BAILEY Officer/Authorized Official 203-609-1168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MD MDSBW) |
| Enumeration Date | 2014-01-20 |
| Last Update Date | 2025-01-09 |