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General NPI Number Information
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NPI Number | 1023953858
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Entity Type | Organization
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Legal Business Name | FCN SURGERY CENTER, LLC
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 6406 FLEET ST
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City | REGO PARK
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State | NY
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Zip | 11374-5243
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Country | US
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Telephone | 718-896-3080
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Fax |
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Provider Business Mailing Address
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Address Line | 718 BROUGHTON ST
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City | ORANGEBURG
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State | SC
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Zip | 29115-6648
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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 | CEO
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Name | KEVIN RAY
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Credential | DPM
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Telephone | 917-405-7881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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