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General NPI Number Information
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NPI Number | 1083481188
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Entity Type | Organization
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Legal Business Name | PIONEER MEDICAL CARE GROUP LLC
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Dates
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Enumeration Date | 12/08/2023
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 1300 MAIN AVE STE 2C
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City | CLIFTON
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State | NJ
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Zip | 07011-2266
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Country | US
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Telephone | 973-417-0181
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 MAIN AVE STE 2C
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City | CLIFTON
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State | NJ
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Zip | 07011-2266
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | RON HILL
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Credential |
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Telephone | 202-985-2191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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