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General NPI Number Information
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NPI Number | 1003935727
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Entity Type | Individual
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Provider Name | JASON A SOSCIA O.D.
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Gender | Male
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1920 MINERAL SPRING AVE
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City | NORTH PROVIDENCE
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State | RI
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Zip | 02904-3742
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Country | US
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Telephone | 401-353-9020
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Fax |
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Provider Business Mailing Address
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Address Line | 201 CORNELL ST
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City | CRANSTON
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State | RI
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Zip | 02920-4046
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Country | US
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Telephone | 401-573-2411
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | ODTA00489
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License Number State | RI
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