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NPI 1073607883

NPI 1073607883 : WILLIAM HOLSTON ANDREWS LICENSED CERTIFIED S : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1073607883
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    Entity Type          |    Individual 
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    Provider Name        |    WILLIAM HOLSTON ANDREWS LICENSED CERTIFIED S
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/03/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    7 LEXINGTON AVE P2
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10010-5517
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    Country              |    US
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    Telephone            |    212-996-0518
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    413 EAST 90TH STREET 2E
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10128-4246
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    Country              |    US
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    Telephone            |    212-996-0518
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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        |    103T00000X
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    Taxonomy Name        |    Psychologist
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    License Number       |    PR0522791
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    License Number State |    NY
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