Provider Demographics
NPI:1871694562
Name:TARABAN, IRINA (MD)
Entity type:Individual
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First Name:IRINA
Middle Name:
Last Name:TARABAN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:605 WEST AVENUE
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06850-4004
Mailing Address - Country:US
Mailing Address - Phone:203-853-5000
Mailing Address - Fax:203-853-5001
Practice Address - Street 1:637 WEST AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06850-4004
Practice Address - Country:US
Practice Address - Phone:203-853-5000
Practice Address - Fax:203-853-5001
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2021-03-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT0381582084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001381582Medicaid
CT001381582Medicaid
CT130000529Medicare ID - Type Unspecified