| NPI | 1821180621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL JUSTIN LICATA Owner/Physician 860-443-0305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: CT 000413) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2007-12-03 |