| NPI | 1952333882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN BAILEY Officer 203-609-1168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MD A1065) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2024-11-08 |