| Provider Type: | Other Service Providers |
| Provider Classification: | Specialist |
| Definition of Specialization: | |
| Address: |
245 Amity Rd. Suite 107 Woodbridge, CT 06525-1439 |
| Phone: | (203) 228-5123 |
| Fax: | (203) 228-5124 |
| Gender: | Male |
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