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General NPI Number Information
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NPI Number | 1265612865
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Entity Type | Organization
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Legal Business Name | CENTRAL RADIOLOGY SERVICES
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Dates
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Enumeration Date | 11/12/2007
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Last Update Date | 11/12/2007
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Provider Practice Location Address
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Address Line | 7901 METROPOLITAN AVE
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City | MIDDLE VILLAGE
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State | NY
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Zip | 11379-2930
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Country | US
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Telephone | 718-326-2727
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Fax | 718-360-9001
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Provider Business Mailing Address
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Address Line | 7901 METROPOLITAN AVE
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City | MIDDLE VILLAGE
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State | NY
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Zip | 11379-2930
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Country | US
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Telephone | 718-326-2727
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Fax | 718-360-9001
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ALLEN ROTHPEARL
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Credential | M.D.
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Telephone | 718-326-2727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 179224-4
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License Number State | NY
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