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General NPI Number Information
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NPI Number | 1194135244
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Entity Type | Individual
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Provider Name | SALEHA RIAZ D.O
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Gender | Female
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Dates
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Enumeration Date | 04/29/2014
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 301 E MAIN ST
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City | BAY SHORE
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State | NY
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Zip | 11706-8458
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Country | US
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Telephone | 631-968-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 455 EUREKA AVE
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City | ELMONT
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State | NY
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Zip | 11003-3834
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Country | US
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Telephone | 917-657-6537
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 300079-01
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License Number State | NY
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