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General NPI Number Information
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NPI Number | 1114339819
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Entity Type | Organization
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Legal Business Name | NEW DIMENSIONS
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Dates
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Enumeration Date | 05/29/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 332 FAYETTE ST
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City | MANLIUS
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State | NY
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Zip | 13104-1609
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Country | US
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Telephone | 315-682-7760
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Fax |
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Provider Business Mailing Address
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Address Line | 332 FAYETTE ST
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City | MANLIUS
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State | NY
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Zip | 13104-1609
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Country | US
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Telephone | 315-682-7760
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LOIS ROSS
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Credential |
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Telephone | 315-682-7760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State | NY
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