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General NPI Number Information
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NPI Number | 1174707251
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Entity Type | Organization
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Legal Business Name | MOSHE H SHIRAZI MD PLLC
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Dates
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Enumeration Date | 12/24/2007
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Last Update Date | 09/27/2010
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Provider Practice Location Address
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Address Line | 700 OLD COUNTRY RD SUITE 202
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City | PLAINVIEW
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State | NY
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Zip | 11803
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Country | US
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Telephone | 516-433-4828
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Fax | 516-433-1895
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Provider Business Mailing Address
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Address Line | 700 OLD COUNTRY RD SUITE 202
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City | PLAINVIEW
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State | NY
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Zip | 11803
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Country | US
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Telephone | 516-433-4828
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Fax | 516-433-1895
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Authorized Official
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Title or Position | OWNER
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Name | FARHAD H SHIRAZI
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Credential | MD
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Telephone | 516-433-4828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 196396
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License Number State | NY
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