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General NPI Number Information
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NPI Number | 1093095556
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Entity Type | Individual
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Provider Name | LAUREN KOCH
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Gender | Female
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Dates
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Enumeration Date | 08/27/2011
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Last Update Date | 01/11/2016
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Provider Practice Location Address
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Address Line | 99 BEAUVOIR AVE BOX 270
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City | SUMMIT
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State | NJ
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Zip | 07901-3533
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Country | US
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Telephone | 908-522-5963
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Fax |
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Provider Business Mailing Address
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Address Line | 18 CRESCENT PL
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City | SHORT HILLS
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State | NJ
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Zip | 07078-3411
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Country | US
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Telephone | 513-313-8099
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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 | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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