| NPI | 1760714661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL LANCE GERSTENFELD Manager 203-773-1935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: CT 031959) |
| Enumeration Date | 2010-02-03 |
| Last Update Date | 2010-02-03 |