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NPI 1164781928

NPI 1164781928 : NICOLA SIMONE SINCLAIR OTR : BROOKLYN, NY

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General NPI Number Information
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    NPI Number           |    1164781928
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    Entity Type          |    Individual 
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    Provider Name        |    NICOLA SIMONE SINCLAIR OTR
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/14/2012
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    Last Update Date     |    05/14/2012
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Provider Practice Location Address
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    Address Line         |    1023 NEW YORK AVE 
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    City                 |    BROOKLYN
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    State                |    NY
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    Zip                  |    11203-3806
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    Country              |    US
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    Telephone            |    347-678-3601
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1023 NEW YORK AVE 
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    City                 |    BROOKLYN
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    State                |    NY
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    Zip                  |    11203-3806
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    Country              |    US
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    Telephone            |    347-678-3601
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    Fax                  |    
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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        |    225XP0200X
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    Taxonomy Name        |    Pediatric Occupational Therapist
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    License Number       |    0157221-1
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    License Number State |    NY
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