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General NPI Number Information
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NPI Number | 1265044275
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Entity Type | Individual
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Provider Name | STEVEN MICHAEL WARDEN RDN
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Gender | Male
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Dates
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Enumeration Date | 08/20/2020
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 1990 WHITEHAVEN RD
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City | GRAND ISLAND
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State | NY
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Zip | 14072-1846
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Country | US
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Telephone | 716-704-0684
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Fax | 716-625-1236
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Provider Business Mailing Address
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Address Line | 2000 METROPICA WAY APT 506
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City | SUNRISE
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State | FL
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Zip | 33323-3218
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Country | US
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Telephone | 716-969-3032
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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 | 133VN1501X
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Taxonomy Name | Sports Dietetics Nutrition Registered Dietitian
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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 | 133VN1006X
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Taxonomy Name | Metabolic Nutrition Registered Dietitian
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License Number | 010390
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License Number State | NY
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