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1063265064
DARIA IVENITSKY
FARMINGTON, CT
NPI
1063265064
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Entity Type
Individual
Gender
N/A
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-04-09
Last Update Date
2024-04-09
Business Address
DARIA IVENITSKY DO
263 FARMINGTON AVENUE
FARMINGTON, CT 06030-1127
Phone number: 860-679-3600
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Mailing Address
DARIA IVENITSKY DO
263 FARMINGTON AVE
FARMINGTON, CT 06030-1921
Phone number: 860-679-2147
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