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Individual

SHIEVA L GHOFRANY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1275 SUMMER ST, SUITE A2, STAMFORD, CT 06905-5359
(203) 353-9099
(203) 353-9699
Mailing address
1275 SUMMER ST, SUITE A2, STAMFORD, CT 06905-5359
(203) 353-9099
(203) 353-9699

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
041579
CT
207V00000X
Obstetrics & Gynecology Physician
Primary
014579
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041579
LICENSE
CT
Enumeration date
09/20/2006
Last updated
02/17/2012
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