| NPI | 1912933680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN BAILEY Officer / Authorized Official 203-609-1168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: PA 45231500) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2025-01-14 |