| NPI | 1811186679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN AGNES FORNO Office Manager 203-364-1936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 000495) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2009-03-24 |