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General NPI Number Information
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NPI Number | 1164364691
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Entity Type | Organization
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Legal Business Name | VIVONOVA HEALTH PLLC
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Dates
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Enumeration Date | 04/06/2026
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Last Update Date | 04/06/2026
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Provider Practice Location Address
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Address Line | 15 WALNUT AVE.
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City | TRUMBULL
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State | CT
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Zip | 06611
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Country | US
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Telephone | 203-267-9787
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Fax | 203-549-0651
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Provider Business Mailing Address
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Address Line | 2299 SUMMER ST # 1157
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City | STAMFORD
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State | CT
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Zip | 06905-4502
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Country | US
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Telephone | 203-267-9787
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Fax | 203-549-0651
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Authorized Official
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Title or Position | CEO
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Name | RUTH ASANTE
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Credential |
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Telephone | 203-267-9787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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