| NPI | 1831386317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAYDEE L. LANCMAN Owner 203-323-8171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine (Licence: CT 037157) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 037157) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: CT 003351) | |
| Enumeration Date | 2007-09-28 |
| Last Update Date | 2011-09-08 |