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General NPI Number Information
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NPI Number | 1255729794
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Entity Type | Organization
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Legal Business Name | NEW YORK PAIN RELIEF MEDICINE PLLC
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Dates
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Enumeration Date | 01/07/2015
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Last Update Date | 01/07/2015
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Provider Practice Location Address
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Address Line | 1673 SHERBOURNE RD
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City | VALLEY STREAM
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State | NY
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Zip | 11580-1829
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Country | US
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Telephone | 917-724-1886
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Fax | 347-227-1368
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Provider Business Mailing Address
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Address Line | 1673 SHERBOURNE RD
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City | VALLEY STREAM
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State | NY
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Zip | 11580-1829
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Country | US
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Telephone | 917-724-1886
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Fax | 347-227-1368
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. SUELANE DO OURO
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Credential | M.D.
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Telephone | 917-724-1886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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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 | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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