| NPI | 1699703686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOLLIE MELBOURNE President CEO 203-332-3501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: CT 0032) |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CT 0032) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CT 0454) | |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: CT 0454) | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CT 0032) | |
| 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: CT 0032) | |
| 261QP2300X Clinic/Center, Primary Care (Licence: CT 0032) | |
| 261QP2300X Clinic/Center, Primary Care (Licence: CT 0454) | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2022-04-28 |