| NPI | 1902394208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON JESSE ROBERTO Owner 203-747-8728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 56428) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CT 56428) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2018-04-23 |