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General NPI Number Information
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NPI Number | 1013084763
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Entity Type | Individual
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Provider Name | DINA MARIE PUGLISSI RPAC
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Gender | Female
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 08/02/2023
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Provider Practice Location Address
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Address Line | 54 NEW HYDE PARK RD
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City | GARDEN CITY
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State | NY
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Zip | 11530-3909
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Country | US
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Telephone | 516-488-1313
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Fax | 516-488-3449
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Provider Business Mailing Address
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Address Line | 46 PHIPPS AVE
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City | EAST ROCKAWAY
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State | NY
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Zip | 11518-1403
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Country | US
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Telephone | 516-593-2733
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 6403-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 6403-1
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License Number State | NY
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