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General NPI Number Information
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NPI Number | 1215902242
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Entity Type | Individual
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Provider Name | MAX A BULMASH
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Gender | Male
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 07/13/2017
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Provider Practice Location Address
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Address Line | 3904 16TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11218-5500
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Country | US
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Telephone | 718-851-8080
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Fax | 718-871-8808
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Provider Business Mailing Address
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Address Line | PO BOX 190421
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City | BROOKLYN
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State | NY
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Zip | 11219-0421
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Country | US
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Telephone |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 146343
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License Number State | NY
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