| NPI | 1942883764 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCILLE FORMEISTER Dir. Bus Syst EMS 860-667-9542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2021-04-29 |