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General NPI Number Information
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NPI Number | 1265647713
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Entity Type | Individual
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Provider Name | LARISA YELUNINA M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 03/15/2017
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Provider Practice Location Address
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Address Line | 675 TOWER AVE STE 301
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City | HARTFORD
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State | CT
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Zip | 06112-1274
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Country | US
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Telephone | 860-714-2750
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Fax |
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Provider Business Mailing Address
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Address Line | 675 TOWER AVE STE 301
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City | HARTFORD
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State | CT
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Zip | 06112-1274
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Country | US
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Telephone | 860-714-2750
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Fax | 860-714-8591
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 048293
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License Number State | CT
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