Individual
DANIL ANISIMOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
20 RESEARCH PKWY, OLD SAYBROOK, CT 06475-4214
(800) 370-3651
(860) 510-0020
Mailing address
31 RICHARDS GROVE RD, QUAKER HILL, CT 06375-1524
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
4165
CT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4165
CT
Other
Enumeration date
08/27/2009
Last updated
04/28/2017
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