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General NPI Number Information
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NPI Number | 1225348881
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Entity Type | Individual
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Provider Name | MARYANN BUONO
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Gender | Female
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Dates
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Enumeration Date | 10/18/2010
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Last Update Date | 10/18/2010
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Provider Practice Location Address
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Address Line | 11515 101ST AVE
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City | SOUTH RICHMOND HILL
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State | NY
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Zip | 11419-1247
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Country | US
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Telephone | 718-441-5333
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Fax |
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Provider Business Mailing Address
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Address Line | 18 RAYMOND CT
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City | GARDEN CITY
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State | NY
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Zip | 11530-4712
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Country | US
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Telephone | 516-465-1204
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 009237-1
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License Number State | NY
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