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General NPI Number Information
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NPI Number | 1235347287
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Entity Type | Individual
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Provider Name | JOSEPH CALABRESE II PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 26 CENTRAL ST BEHAVIORAL MEDICINE PROGRAM
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City | SOMERVILLE
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State | MA
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Zip | 02143-2827
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Country | US
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Telephone | 617-575-5332
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Fax |
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Provider Business Mailing Address
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Address Line | 60 POWDER HOUSE RD
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City | MEDFORD
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State | MA
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Zip | 02155-2947
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Country | US
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Telephone | 781-874-9422
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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