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General NPI Number Information
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NPI Number | 1063588036
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Entity Type | Individual
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Provider Name | JOANN MARX C.P.O., F.A.A.O.P
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Gender | Female
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 79 MIDDLEVILLE RD PROSTHETIC DEPT. BLD. 200, 4TH FLOOR
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City | NORTHPORT
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State | NY
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Zip | 11768-2200
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Country | US
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Telephone | 631-754-7936
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Fax | 631-754-7965
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Provider Business Mailing Address
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Address Line | 1659 LINCOLN AVE
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City | BOHEMIA
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State | NY
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Zip | 11716-1415
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Country | US
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Telephone | 631-563-1881
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Fax | 631-563-7237
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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 | 222Z00000X
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Taxonomy Name | Orthotist
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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 | 224P00000X
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Taxonomy Name | Prosthetist
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License Number |
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License Number State |
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