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General NPI Number Information
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NPI Number | 1316332752
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Entity Type | Individual
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Provider Name | FANNI RATZON MD
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Gender | Female
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Dates
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Enumeration Date | 04/02/2015
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 5 PERRYRIDGE RD
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City | GREENWICH
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State | CT
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Zip | 06830-4608
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Country | US
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Telephone | 203-785-7037
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Fax |
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Provider Business Mailing Address
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Address Line | 99 E RIVER DR FL 5
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City | EAST HARTFORD
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State | CT
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Zip | 06108-7301
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Country | US
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Telephone | 860-282-4104
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Fax |
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 25MA11155700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 79500
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License Number State | CT
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