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General NPI Number Information
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NPI Number | 1104981687
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Entity Type | Organization
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Legal Business Name | LOUIS M. MAISEL, MD, PC
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 01/11/2011
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Provider Practice Location Address
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Address Line | 20 SQUADRON BLVD SUITE 102
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City | NEW CITY
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State | NY
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Zip | 10956-5200
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Country | US
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Telephone | 845-708-0900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 547
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City | NEW CITY
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State | NY
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Zip | 10956-0547
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Country | US
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Telephone | 845-708-0900
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. LOUIS M. MAISEL
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Credential | MD
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Telephone | 845-708-0900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 178980
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License Number State | NY
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