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NPI 1245300573

NPI 1245300573 : ANNA EFTHYMIOU KANES O.D. : FLORAL PARK, NY

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General NPI Number Information
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    NPI Number           |    1245300573
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    Entity Type          |    Individual 
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    Provider Name        |    ANNA EFTHYMIOU KANES O.D.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/08/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    224 JERICHO TPKE 
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    City                 |    FLORAL PARK
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    State                |    NY
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    Zip                  |    11001-2159
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    Country              |    US
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    Telephone            |    516-354-4160
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    Fax                  |    516-354-4409
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Provider Business Mailing Address
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    Address Line         |    224 JERICHO TPKE 
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    City                 |    FLORAL PARK
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    State                |    NY
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    Zip                  |    11001-2159
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    Country              |    US
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    Telephone            |    516-354-4160
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    Fax                  |    516-354-4409
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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       |    5218
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    License Number State |    NY
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