Graduated: 2013
NPI: 1841753225
Practice Locations (3)
NORTHEAST MEDICAL GROUP INC
20 YORK ST
NEW HAVEN, CT 065103220
2036881378
GAYLORD HOSPITAL, INC.
50 GAYLORD FARM RD
WALLINGFORD, CT 064922828
2032842800
PROSPECT CT MEDICAL FOUNDATION INC
64 ROBBINS ST
WATERBURY, CT 067082613
2035736263
Source: CMS National Downloadable File, September 2026.