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Individual

ROSTISLAVA KANYUK-STOUPNITSKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
138 HAVERHILL STREET, ANDOVER, MA 01810
(978) 296-2302
(978) 296-2304
Mailing address
PO BOX 9132, BROOKLINE, MA 02446
(978) 296-2302
(978) 296-2304

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
233627
MA
207L00000X
Anesthesiology Physician
38662
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
129960
FALLON
01
1477614196
UHC
05
2142171
MA
05
30207632
NH
01
41844
NHP
01
459069
TUFTS
01
8961939
CIGNA
01
95855401
NETWORK HEALTH
01
AA97507
HPHC
01
J42642
BCBS
Enumeration date
12/13/2006
Last updated
01/21/2010
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