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General NPI Number Information
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NPI Number | 1255482295
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Entity Type | Individual
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Provider Name | DEAN CORY MITCHELL MD
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 57 W 57TH ST STE 601
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City | NEW YORK
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State | NY
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Zip | 10019-2802
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Country | US
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Telephone | 212-397-0157
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Fax | 212-586-6880
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Provider Business Mailing Address
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Address Line | 165 NORTH VIALLGE AVENUE SUITE #129
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570
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Country | US
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Telephone | 516-678-9600
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Fax | 516-678-9618
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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 | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 170802
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License Number State | NY
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