| NPI | 1902957970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME MARTIN Practice Manager 203-334-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2017-03-13 |