| NPI | 1679985501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL AUYANG Clinical Director 203-317-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251S00000X (Licence: CT OPCC-74) |
| 251S00000X (Licence: CT DPH 0584) | |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2020-10-06 |