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General NPI Number Information
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NPI Number | 1124335047
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Entity Type | Organization
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Legal Business Name | CYPRESS HEALTH INSTITUTE OF NEW JERSEY
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Dates
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Enumeration Date | 09/13/2010
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Last Update Date | 02/23/2011
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Provider Practice Location Address
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Address Line | 405 NORTHFIELD AVE SUITE 205
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City | WEST ORANGE
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State | NJ
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Zip | 07052-3026
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Country | US
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Telephone | 973-669-2820
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Fax | 973-669-2930
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Provider Business Mailing Address
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Address Line | PO BOX 599
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City | MONTCLAIR
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State | NJ
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Zip | 07042-0599
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Country | US
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Telephone | 973-669-2820
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Fax | 973-669-2930
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. CYNTHIA Y PAIGE
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Credential | MD
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Telephone | 973-669-2820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 25MA056219
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License Number State | NJ
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