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1093257164
TATYANA AXYONOVA
WESTPORT, CT
NPI
1093257164
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: CT 6750)
Enumeration Date
2016-11-07
Last Update Date
2016-11-07
Business Address
-- TATYANA AXYONOVA FNP-BC
830 POST RD E SUITE G3
WESTPORT, CT 06880-5222
Phone number: 203-291-3800
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Mailing Address
-- TATYANA AXYONOVA FNP-BC
9 OUTPOST LN
RIDGEFIELD, CT 06877-3335
Phone number: 248-915-0273
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