| NPI | 1760709802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE SWIFT Owner 203-230-0886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CT 001848) |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2010-04-29 |