| NPI | 1861112831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEDEMAH JOSEPH-FAGBUYI Psychiatric Nurse Practitioner 860-518-7454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2023-07-05 |