| NPI | 1689854192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTA H DONIS Billing Administrator 203-618-0687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CT 033766) |
| Enumeration Date | 2007-11-13 |
| Last Update Date | 2007-11-13 |