| NPI | 1912928169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN LINK Chief Financial Officer Administrat 860-714-7362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 207X00000X Orthopaedic Surgery | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 208000000X Pediatrics | |
| 2080A0000X Pediatrics, Adolescent Medicine | |
| 2080P0008X Pediatrics, Neurodevelopmental Disabilities | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology | |
| 363AS0400X Physician Assistant, Surgical | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: CT 052095) | |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2016-02-09 |