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General NPI Number Information
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NPI Number | 1164481529
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Entity Type | Organization
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Legal Business Name | ST. CHARLES HOSPITAL AND REHABILITATION CENTER
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 200 BELLE TERRE ROAD
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City | PORT JEFFERSON
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State | NY
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Zip | 11714-5713
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Country | US
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Telephone | 631-474-6000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 95000-6570
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City | PHILADELPHIA
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State | PA
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Zip | 19195-6570
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Country | US
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Telephone | 631-474-6000
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAMES O'CONNOR
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Credential |
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Telephone | 631-474-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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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 | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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