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General NPI Number Information
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NPI Number | 1174386007
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Entity Type | Individual
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Provider Name | VICTORIA CAGLE OTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/02/2024
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 540 PRESIDENT ST STE 1E
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City | BROOKLYN
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State | NY
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Zip | 11215-1491
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Country | US
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Telephone | 718-858-0088
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Fax |
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Provider Business Mailing Address
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Address Line | 681 W 193RD ST APT 3C
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City | NEW YORK
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State | NY
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Zip | 10040-2735
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Country | US
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Telephone | 504-655-8617
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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 | 028851
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License Number State | NY
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