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General NPI Number Information
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NPI Number | 1194791863
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Entity Type | Individual
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Provider Name | ANN NICOLOFF BECKER MD
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Gender | Female
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 09/06/2007
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Provider Practice Location Address
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Address Line | 332 WASHINGTON ST SUITE 275
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City | WELLESLEY
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State | MA
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Zip | 02481-6219
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Country | US
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Telephone | 781-235-7730
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Fax |
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Provider Business Mailing Address
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Address Line | 1227 HIGH ST
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City | WESTWOOD
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State | MA
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Zip | 02090-2764
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Country | US
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Telephone | 781-255-5963
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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 | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 73532
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License Number State | MA
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