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General NPI Number Information
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NPI Number | 1134768591
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Entity Type | Organization
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Legal Business Name | HOUSE MEDICAL PLLC
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Dates
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Enumeration Date | 01/03/2020
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Last Update Date | 12/07/2022
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Provider Practice Location Address
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Address Line | 5018 EXPRESS DR S
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City | RONKONKOMA
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State | NY
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Zip | 11779-5589
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Country | US
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Telephone | 833-266-7171
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Fax | 631-209-5129
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Provider Business Mailing Address
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Address Line | 5018 EXPRESS DR S
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City | RONKONKOMA
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State | NY
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Zip | 11779-5589
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Country | US
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Telephone | 833-266-7171
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Fax | 631-209-5129
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Authorized Official
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Title or Position | OWNER/ PHYSICIAN
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Name | SUNIL SHARMA
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Credential | MD
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Telephone | 833-266-7171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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