| NPI | 1700939063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL MENDILLO Practice Manager 203-865-3852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-08-22 |