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General NPI Number Information
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NPI Number | 1255618203
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Entity Type | Organization
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Legal Business Name | ALLERGY CARE PLLC
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Dates
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Enumeration Date | 11/04/2011
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Last Update Date | 11/04/2011
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Provider Practice Location Address
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Address Line | 2206 GENESEE ST SUITE 303
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City | UTICA
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State | NY
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Zip | 13502-5829
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Country | US
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Telephone | 315-624-7911
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Fax | 315-624-7912
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Provider Business Mailing Address
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Address Line | 2206 GENESEE ST SUITE 303
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City | UTICA
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State | NY
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Zip | 13502-5829
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Country | US
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Telephone | 315-624-7911
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Fax | 315-624-7912
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | LUDWIG E KHOURY
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Credential | MD
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Telephone | 315-624-7911
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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 | 241599
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License Number State | NY
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