| NPI | 1811387848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN O ENDERLE Sr. Vice Presidient 860-221-0793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2015-01-29 |
| Last Update Date | 2015-01-29 |