| NPI | 1851510929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN SERKEY Practice Administrator 860-358-4802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208600000X Surgery | |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2019-07-01 |