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General NPI Number Information
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NPI Number | 1003932849
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Entity Type | Individual
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Provider Name | JOSE ABEL PELAEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 21 AUDUBON AVE
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City | NEW YORK
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State | NY
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Zip | 10032
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Country | US
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Telephone | 212-342-4700
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Fax | 212-342-4725
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Provider Business Mailing Address
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Address Line | 4051 68TH ST
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City | WOODSIDE
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State | NY
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Zip | 11377-3831
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Country | US
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Telephone | 718-639-2473
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Fax | 212-342-4725
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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 | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 130084
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License Number State | NY
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