Provider Demographics
NPI:1497892251
Name:STAVREVA-ZLATAREVA, DANIELLA SLAVCHEVA (MD)
Entity Type:Individual
Prefix:
First Name:DANIELLA
Middle Name:SLAVCHEVA
Last Name:STAVREVA-ZLATAREVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DANIELLA
Other - Middle Name:S
Other - Last Name:STAVREVA-ZLATAREVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:20 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-5238
Mailing Address - Country:US
Mailing Address - Phone:203-629-2822
Mailing Address - Fax:203-629-2940
Practice Address - Street 1:20 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-5238
Practice Address - Country:US
Practice Address - Phone:203-629-2822
Practice Address - Fax:203-629-2940
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0424602084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry