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General NPI Number Information
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NPI Number | 1235189382
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Entity Type | Individual
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Provider Name | PHILIP COHEN O.D
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 02/09/2009
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Provider Practice Location Address
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Address Line | 2950 E WATTLES RD SUITE 100
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City | TROY
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State | MI
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Zip | 48085-7008
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Country | US
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Telephone | 248-740-0222
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Fax | 248-689-0123
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Provider Business Mailing Address
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Address Line | 2950 E WATTLES RD SUITE 100
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City | TROY
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State | MI
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Zip | 48085-7008
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Country | US
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Telephone | 248-740-0222
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Fax | 248-689-0123
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4901002367
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License Number State | MI
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