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General NPI Number Information
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NPI Number | 1083054217
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Entity Type | Individual
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Provider Name | AMOOLYA RAO O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/02/2013
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | COASTAL EYE 600 W PUTNAM AVE, LOWER LEVEL
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City | GREENWICH
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State | CT
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Zip | 06830
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Country | US
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Telephone | 203-900-4011
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Fax |
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Provider Business Mailing Address
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Address Line | 28 BELLTOWN RD APT 7
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City | STAMFORD
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State | CT
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Zip | 06905-3725
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Country | US
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Telephone | 630-788-0823
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2928
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License Number State | CT
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