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General NPI Number Information
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NPI Number | 1144336538
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Entity Type | Individual
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Provider Name | SYMEON MISSIOS M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 10/17/2019
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Provider Practice Location Address
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Address Line | 1175 MONTAUK HWY STE 6
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City | WEST ISLIP
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State | NY
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Zip | 11795-4939
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Country | US
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Telephone | 631-422-5371
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Fax | 330-665-6748
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Provider Business Mailing Address
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Address Line | 1175 MONTAUK HWY STE 6
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City | WEST ISLIP
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State | NY
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Zip | 11795-4939
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Country | US
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Telephone | 631-422-5371
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Fax | 330-665-6748
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 35124092
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | MD.206973
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License Number State | LA
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