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NPI 1285948075

NPI 1285948075 : KRISTEN WALKER : BAYSIDE, NY

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General NPI Number Information
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    NPI Number           |    1285948075
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    Entity Type          |    Individual 
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    Provider Name        |    KRISTEN WALKER
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/04/2010
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    Last Update Date     |    08/04/2010
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Provider Practice Location Address
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    Address Line         |    3555 223RD ST 
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    City                 |    BAYSIDE
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    State                |    NY
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    Zip                  |    11361-2236
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    Country              |    US
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    Telephone            |    718-428-5370
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    9 VAN ROO AVE 
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    City                 |    MERRICK
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    State                |    NY
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    Zip                  |    11566-3111
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    Country              |    US
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    Telephone            |    516-655-9207
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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        |    225XP0200X
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    Taxonomy Name        |    Pediatric Occupational Therapist
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    License Number       |    014327-1
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    License Number State |    NY
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