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General NPI Number Information
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NPI Number | 1033795463
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Entity Type | Organization
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Legal Business Name | CARE ACTIVE MEDICAL PC
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Dates
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Enumeration Date | 03/24/2021
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 265 SUNRISE HWY STE 325
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-4912
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Country | US
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Telephone | 516-380-1333
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Fax |
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Provider Business Mailing Address
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Address Line | 265 SUNRISE HWY STE 325
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-4912
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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 | PRESIDENT
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Name | DR. MITCHELL ALAN COHN
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Credential | MD
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Telephone | 516-380-1333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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