| NPI | 1912463423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAIYE OGUNDIPE Manager 860-918-8859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine |
| 2084B0002X Psychiatry & Neurology Obesity Medicine | |
| 2084F0202X Psychiatry & Neurology Forensic Psychiatry | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| 2084S0012X Psychiatry & Neurology Sleep Medicine | |
| Enumeration Date | 2019-02-20 |
| Last Update Date | 2019-03-05 |