Graduated: 2007
NPI: 1790162790
Practice Locations (2)
PROSPECT CT MEDICAL FOUNDATION INC
64 ROBBINS ST
WATERBURY, CT 067082613
2035736263
STAYWELL HEALTH CARE INC.
80 PHOENIX AVE
WATERBURY, CT 067021418
2037575491
Source: CMS National Downloadable File, September 2026.