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General NPI Number Information
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NPI Number | 1174576987
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Entity Type | Individual
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Provider Name | LAWRENCE SUMNER COHEN O.D.
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Gender | Male
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 08/31/2021
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Provider Practice Location Address
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Address Line | 620 GEORGE WASHINGTON HWY TARGET OPTICAL
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City | LINCOLN
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State | RI
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Zip | 02864-4293
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Country | US
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Telephone | 401-642-0080
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Fax | 508-923-9894
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Provider Business Mailing Address
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Address Line | 54 MAIN ST STE 10
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City | LAKEVILLE
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State | MA
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Zip | 02347-3622
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Country | US
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Telephone | 508-336-1199
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Fax | 508-923-9894
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3586
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | CODTG00688
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License Number State | RI
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