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General NPI Number Information
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NPI Number | 1275973513
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Entity Type | Individual
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Provider Name | AMY VINOD JASANI O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/01/2013
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Last Update Date | 06/05/2019
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Provider Practice Location Address
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Address Line | 131 MADISON AVE STE 130
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City | MORRISTOWN
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State | NJ
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Zip | 07960-7360
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Country | US
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Telephone | 973-267-1113
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Fax | 973-267-0719
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Provider Business Mailing Address
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Address Line | 2141 ROUTE 38 APT 1008
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City | CHERRY HILL
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State | NJ
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Zip | 08002-4215
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Country | US
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Telephone | 973-807-2616
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV007980
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00652300
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License Number State | NJ
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