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General NPI Number Information
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NPI Number | 1235369059
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Entity Type | Organization
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Legal Business Name | LABORATORY OF PODIATRIC PATHOLOGY, P.C.
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Dates
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Enumeration Date | 07/15/2009
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Last Update Date | 07/15/2009
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Provider Practice Location Address
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Address Line | 801 ARCH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-2413
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Country | US
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Telephone | 215-238-9831
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Fax | 215-238-1873
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Provider Business Mailing Address
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Address Line | 801 ARCH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-2413
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Country | US
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Telephone | 215-238-9831
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Fax | 215-238-1873
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Authorized Official
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Title or Position | PODIATRIST/LABORATORY DIRECTOR
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Name | DR. HARVEY LEMONT
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Credential | DPM
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Telephone | 215-238-9831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 021451
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License Number State | PA
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