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NPI 1265162655

NPI 1265162655 : SHAMA SUBRAMONY : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1265162655
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    Entity Type          |    Individual 
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    Provider Name        |    SHAMA SUBRAMONY
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/16/2022
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    Last Update Date     |    06/16/2022
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Provider Practice Location Address
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    Address Line         |    410 E 92ND ST 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10128-6881
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    Country              |    US
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    Telephone            |    212-831-3667
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    430 E 20TH ST APT 7D 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10009-8204
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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        |    103TS0200X
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    Taxonomy Name        |    School Psychologist
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    License Number       |    
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    License Number State |    NY
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