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General NPI Number Information
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NPI Number | 1073852596
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Entity Type | Individual
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Provider Name | MR. RAYMOND M AMEJKO
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Gender | Male
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 03/05/2021
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Provider Practice Location Address
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Address Line | 5421 E HARMON AVE C-19
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City | LAS VEGAS
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State | NV
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Zip | 89122-6058
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Country | US
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Telephone | 702-595-8392
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Fax |
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Provider Business Mailing Address
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Address Line | 525 HARRIS ST APT 423
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City | HENDERSON
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State | NV
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Zip | 89015-6166
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Country | US
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Telephone | 702-762-2803
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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