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General NPI Number Information
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NPI Number | 1184151003
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Entity Type | Organization
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Legal Business Name | LONG ISLAND PODIATRY GROUP, P.C.
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Dates
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Enumeration Date | 05/23/2017
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Last Update Date | 07/18/2024
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Provider Practice Location Address
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Address Line | 1991 MARCUS AVE STE M103
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-2040
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Country | US
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Telephone | 516-327-0074
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Fax | 516-327-0083
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Provider Business Mailing Address
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Address Line | 375 N CENTRAL AVE
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City | VALLEY STREAM
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State | NY
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Zip | 11580-1156
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Country | US
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Telephone | 516-825-4070
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Fax | 516-568-2318
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RUSSELL CAPRIOLI
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Credential | DPM
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Telephone | 516-837-9268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State | NY
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