| NPI | 1972365609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIANNA LEHNING QUEIROS Vice President 203-513-3211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2024-01-29 |