| NPI | 1770014656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER SIRCH Manager 203-215-9179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CT 52588) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2017-03-23 |