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General NPI Number Information
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NPI Number | 1265513147
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Entity Type | Individual
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Provider Name | BRUCE ALBERT ALESSIO MED CAGS
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Gender | Male
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 10/12/2008
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Provider Practice Location Address
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Address Line | 789 CLAPBOARDTREE STREET HARBOR COUNSELING CENTER
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City | WESTWOOD
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State | MA
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Zip | 02090
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Country | US
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Telephone | 781-762-4001
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Fax |
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Provider Business Mailing Address
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Address Line | 541 MARRETT RD
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City | LEXINGTON
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State | MA
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Zip | 02421-7608
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Country | US
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Telephone | 781-863-8495
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 035
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License Number State | MA
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