| NPI | 1790813590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD MAHLON SHOUP Owner 860-432-5600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 207RS0012X Internal Medicine, Sleep Medicine |
| 2084S0012X Psychiatry & Neurology, Sleep Medicine | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2013-12-04 |