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General NPI Number Information
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NPI Number | 1245851930
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Entity Type | Individual
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Provider Name | OZ MENACHEM HASIS PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 05/04/2020
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 470 CEDARHURST AVE
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City | CEDARHURST
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State | NY
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Zip | 11516-1217
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Country | US
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Telephone | 347-302-6214
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Fax |
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Provider Business Mailing Address
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Address Line | 177 WANSER AVE
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City | INWOOD
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State | NY
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Zip | 11096-2114
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Country | US
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Telephone |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 802625
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 405507
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License Number State | NY
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