| NPI | 1821270513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH F MARICI President 860-354-5511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 036520) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health |
| 363LF0000X Nurse Practitioner Family (Licence: CT 001512) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2024-08-14 |