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General NPI Number Information
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NPI Number | 1285886945
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Entity Type | Organization
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Legal Business Name | MARSHALL GASTROINTESTINAL ENDOSCOPY, PC
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Dates
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Enumeration Date | 10/14/2008
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Last Update Date | 10/14/2008
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Provider Practice Location Address
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Address Line | 1800 ROCKAWAY AVE SUITE 201
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City | HEWLETT
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State | NY
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Zip | 11557-1665
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Country | US
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Telephone | 516-593-4200
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Fax | 516-887-9120
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Provider Business Mailing Address
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Address Line | 1800 ROCKAWAY AVE SUITE 201
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City | HEWLETT
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State | NY
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Zip | 11557-1665
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Country | US
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Telephone | 516-593-4200
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Fax | 516-887-9120
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Authorized Official
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Title or Position | PHYSICIAN/PRESIDENT
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Name | ANDREW TODD MARSHALL
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Credential | MD
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Telephone | 516-593-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 193405
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License Number State | NY
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