NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
1104131283 |   |   |   | MASONICARE | 22 MASONIC AVE | WALLINGFORD | CT | 064923048 |
1376791459 | LYONS | LORI | A |   | 22 MASONIC AVE | WALLINGFORD | CT | 064923048 |
1063660280 | VUMBACK | AMY | F |   | 22 MASONIC AVE | WALLINGFORD | CT | 064923048 |