| NPI | 1710248083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELIX EFFA Co Manager 860-461-1361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CT 0000578) |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2013-06-06 |