Individual
IVETA TERKOSOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
555 SUMMER ST, STAMFORD, CT 06901-1413
(203) 570-7512
Mailing address
555 SUMMER ST, STAMFORD, CT 06901-1413
(203) 570-7512
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
003158
CT
Other
Enumeration date
06/29/2009
Last updated
06/29/2009
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