| NPI | 1750769584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK WASSERMAN Medical Director 203-239-2727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: CT 36223) |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2015-05-13 |