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General NPI Number Information
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NPI Number | 1083906416
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Entity Type | Individual
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Provider Name | WAILE RAMADAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/04/2011
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 52 PECK RD
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City | TORRINGTON
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State | CT
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Zip | 06790-6107
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Country | US
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Telephone | 860-489-6899
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Fax |
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Provider Business Mailing Address
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Address Line | 43 BART DR
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City | COLLINSVILLE
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State | CT
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Zip | 06019-3045
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Country | US
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Telephone | 917-573-1849
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 052878
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License Number State | CT
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