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General NPI Number Information
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NPI Number | 1144217670
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Entity Type | Individual
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Provider Name | AMY BETH KOFF M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/30/2005
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Last Update Date | 07/25/2011
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Provider Practice Location Address
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Address Line | 434 ROUTE 134 UNIT 1A
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City | SOUTH DENNIS
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State | MA
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Zip | 02660-3433
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Country | US
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Telephone | 508-394-5556
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Fax | 508-394-2735
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Provider Business Mailing Address
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Address Line | 434 ROUTE 134 UNIT 1A
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City | SOUTH DENNIS
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State | MA
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Zip | 02660-3433
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Country | US
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Telephone | 508-394-5556
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Fax | 508-394-2735
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 80792
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License Number State | MA
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