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General NPI Number Information
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NPI Number | 1134237019
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Entity Type | Individual
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Provider Name | MARK PAUL FABER M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 200 S ORANGE AVE 225
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5817
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Country | US
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Telephone | 973-322-7600
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Fax | 973-322-7310
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Provider Business Mailing Address
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Address Line | 200 S.ORANGE AVENUE 225
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City | LIVINGSTON
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State | NJ
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Zip | 07039
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Country | US
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Telephone | 973-322-7600
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Fax | 973-322-7310
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | MA05664000
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License Number State | NJ
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