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General NPI Number Information
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NPI Number | 1104626753
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Entity Type | Organization
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Legal Business Name | BETA ANGLES CARE
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 712 H ST NE STE 1342
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City | WASHINGTON
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State | DC
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Zip | 20002-3627
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Country | US
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Telephone | 202-471-0360
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Fax |
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Provider Business Mailing Address
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Address Line | 4816 FLORENCE AVE FL 3
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City | PHILADELPHIA
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State | PA
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Zip | 19143-3559
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Country | US
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Telephone | 202-471-0360
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | DR. DAVID C AGOR
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Credential | PMHNP, HIVPCP
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Telephone | 202-471-0360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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