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General NPI Number Information
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NPI Number | 1104158468
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Entity Type | Individual
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Provider Name | MICHAEL ALAN ELROD PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 02/10/2010
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Last Update Date | 02/10/2010
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Provider Practice Location Address
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Address Line | 216 GLEN COVE AVE
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City | CARLE PLACE
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State | NY
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Zip | 11514-1630
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Country | US
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Telephone | 516-334-2847
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Fax |
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Provider Business Mailing Address
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Address Line | 17 E JERICHO TPKE
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City | MINEOLA
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State | NY
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Zip | 11501-3103
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Country | US
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Telephone | 516-873-1998
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Fax | 516-873-7235
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 034351
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License Number State | NY
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