Individual
LARISA LAURA DAVYDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
950 CAMPBELL AVE, WEST HAVEN, CT 06516
(203) 932-5711
(203) 937-4704
Mailing address
950 CAMPBELL AVE, WEST HAVEN, CT 06516
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
043978
CT
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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