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General NPI Number Information
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NPI Number | 1225352347
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Entity Type | Individual
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Provider Name | PAULETTE ALMENA MYRIE R.D. CD-N
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Gender | Female
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Dates
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Enumeration Date | 03/18/2010
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Last Update Date | 04/22/2014
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Provider Practice Location Address
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Address Line | 2534 STEINWAY ST
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City | ASTORIA
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State | NY
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Zip | 11103-3702
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Country | US
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Telephone | 718-777-5243
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Fax | 718-777-5250
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Provider Business Mailing Address
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Address Line | 16118 140TH AVE
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City | JAMAICA
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State | NY
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Zip | 11434-4406
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Country | US
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Telephone | 516-547-3940
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 004572
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License Number State | NY
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