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General NPI Number Information
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NPI Number | 1124367651
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Entity Type | Organization
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Legal Business Name | SCHUYLERVILLE PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 06/28/2013
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Provider Practice Location Address
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Address Line | 43 SPRING ST
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City | SCHUYLERVILLE
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State | NY
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Zip | 12871-1014
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Country | US
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Telephone | 518-595-9471
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Fax |
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Provider Business Mailing Address
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Address Line | 43 SPRING ST
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City | SCHUYLERVILLE
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State | NY
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Zip | 12871-1014
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Country | US
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Telephone | 518-595-9471
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JEFFREY B FEAR
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Credential | MPT
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Telephone | 518-727-2096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 023991-1
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License Number State | NY
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