| NPI | 1700129624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM GODBURN Executive Director COO 203-573-6434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 207T00000X Neurological Surgery | |
| Enumeration Date | 2013-03-28 |
| Last Update Date | 2019-06-18 |