| NPI | 1821036138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN BAILEY Officer/Authorized Official 203-609-1168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: PA 20831501) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2022-11-17 |