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General NPI Number Information
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NPI Number | 1023326097
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Entity Type | Individual
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Provider Name | FRENA LYNNE MANGASER PICAZO M.S., OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/23/2010
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Last Update Date | 09/23/2010
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Provider Practice Location Address
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Address Line | 2785 W 5TH ST
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City | BROOKLYN
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State | NY
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Zip | 11224-4629
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Country | US
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Telephone | 718-266-5585
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Fax | 718-266-5766
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Provider Business Mailing Address
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Address Line | 220 KOSCIUSZKO ST APT 1B
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City | BROOKLYN
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State | NY
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Zip | 11216
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Country | US
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Telephone | 949-280-4896
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 63 016285
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License Number State | NY
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