Provider Demographics
NPI:1275359366
Name:NAZHMIDDINOV, RAVSHANDZHON (APRN)
Entity type:Individual
Prefix:
First Name:RAVSHANDZHON
Middle Name:
Last Name:NAZHMIDDINOV
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 CURRIER WAY
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-1432
Mailing Address - Country:US
Mailing Address - Phone:203-544-3521
Mailing Address - Fax:203-544-3521
Practice Address - Street 1:1 CELLINI PL STE 102
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-1666
Practice Address - Country:US
Practice Address - Phone:203-488-7228
Practice Address - Fax:203-204-1415
Is Sole Proprietor?:No
Enumeration Date:2024-11-23
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT14258363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily