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General NPI Number Information
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NPI Number | 1144462169
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Entity Type | Organization
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Legal Business Name | SUE MALONE PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 04/06/2009
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Last Update Date | 06/15/2009
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Provider Practice Location Address
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Address Line | 22 SHERWOOD DR
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City | NEW MILFORD
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State | CT
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Zip | 06776-3317
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Country | US
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Telephone | 203-417-9433
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Fax | 860-350-0285
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Provider Business Mailing Address
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Address Line | 22 SHERWOOD DR
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City | NEW MILFORD
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State | CT
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Zip | 06776-3317
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Country | US
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Telephone | 203-417-9433
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Fax | 860-350-0285
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Authorized Official
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Title or Position | OWNER
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Name | MS. SUSAN MALONE
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Credential |
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Telephone | 203-417-9433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 004046
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 004046
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License Number State | CT
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