| NPI | 1811514292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANUM SHEIKH AHMED Owner 860-263-8266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2021-02-25 |