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General NPI Number Information
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NPI Number | 1003416355
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Entity Type | Individual
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Provider Name | GINA ALYSSA CAFONE OT-C
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Gender | Female
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 10/27/2020
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Provider Practice Location Address
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Address Line | 2339 ROUTE 70 W FL 2
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City | CHERRY HILL
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State | NJ
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Zip | 08002-3315
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Country | US
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Telephone | 856-547-0201
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Fax |
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Provider Business Mailing Address
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Address Line | 3 COOPER PLZ RM 408
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City | CAMDEN
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State | NJ
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Zip | 08103-1438
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Country | US
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Telephone |
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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 | 246ZX2200X
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Taxonomy Name | Orthopedic Assistant
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License Number | 20-0613
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License Number State | NJ
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