| NPI | 1912305483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER WILLEY Executive Director 203-576-5076 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center Urgent Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2019-03-01 |