| NPI | 1740639913 |
|---|---|
| Former Legal Business Name | CCWC PROFESSIONAL PRACTICE GROUP LLC |
| Entity Type | Organization |
| Authorized Contact | KENNETH PAUL BLAU Managing Partner 203-748-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: CT 030587) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2022-12-05 |