| NPI | 1811315757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA CECILIA BRACAMONTE Clinician I 860-951-8770 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CT 1841301876) |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2014-03-28 |