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NPI 1083095020

NPI 1083095020 : THOMAS LEE ROONEY O.D. : DUNKIRK, MD

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General NPI Number Information
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    NPI Number           |    1083095020
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    Entity Type          |    Individual 
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    Provider Name        |    THOMAS LEE ROONEY O.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/16/2015
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    Last Update Date     |    01/31/2018
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Provider Practice Location Address
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    Address Line         |    10264 SOUTHERN MARYLAND BLVD 
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    City                 |    DUNKIRK
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    State                |    MD
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    Zip                  |    20754-3037
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    Country              |    US
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    Telephone            |    443-964-8705
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    Fax                  |    443-964-8705
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Provider Business Mailing Address
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    Address Line         |    1950 OLD GALLOWS RD STE 520 
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    City                 |    VIENNA
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    State                |    VA
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    Zip                  |    22182-3970
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    Country              |    US
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    Telephone            |    703-847-8899
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    Fax                  |    866-795-4020
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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       |    TA2467
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    License Number State |    MD
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Taxonomy #2
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    Taxonomy Code        |    152WC0802X
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    Taxonomy Name        |    Corneal and Contact Management Optometrist
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    License Number       |    TA2467
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    License Number State |    MD
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