| NPI | 1760172001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN DONOHUE Owner, Np Director 203-895-6572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2024-01-18 |