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General NPI Number Information
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NPI Number | 1205963725
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Entity Type | Individual
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Provider Name | HOOSHANG SHANEHSAZ RPH
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Gender | Male
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 06/17/2013
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Provider Practice Location Address
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Address Line | 100 SUNNYSIDE RD
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City | SMYRNA
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State | DE
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Zip | 19977-1752
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Country | US
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Telephone | 302-223-1370
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Fax | 302-223-1090
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Provider Business Mailing Address
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Address Line | 784 NAULT RD
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City | DOVER
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State | DE
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Zip | 19904-5808
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Country | US
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Telephone | 302-734-9707
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Fax | 302-223-1090
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | A1-0002127
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License Number State | DE
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