| NPI | 1972758183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DUNBAR ILLICK Partner 203-481-0315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CT 0322) |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2022-03-04 |