| NPI | 1720120199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURENCE ANTHONY KIRWAN President Owner 203-838-8844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |