| NPI | 1699456574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIANNE LONGO Chief Clinical Officer 860-990-1335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2023-07-25 |
| Last Update Date | 2023-11-24 |