| NPI | 1861905176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN BAILEY Officer / Authorized Offcial 203-609-1168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2024-09-18 |