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NPI 1083968630

NPI 1083968630 : SHELDON WEINSTEIN L.O. : NEW BRITAIN, CT

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General NPI Number Information
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    NPI Number           |    1083968630
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    Entity Type          |    Individual 
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    Provider Name        |    SHELDON WEINSTEIN L.O.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/05/2012
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    Last Update Date     |    11/05/2012
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Provider Practice Location Address
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    Address Line         |    198 E MAIN ST 
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    City                 |    NEW BRITAIN
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    State                |    CT
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    Zip                  |    06051-1915
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    Country              |    US
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    Telephone            |    860-223-7900
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    198 E MAIN ST 
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    City                 |    NEW BRITAIN
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    State                |    CT
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    Zip                  |    06051-1915
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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    |    
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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        |    156FX1800X
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    Taxonomy Name        |    Optician
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    License Number       |    000787
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    License Number State |    CT
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