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General NPI Number Information
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NPI Number | 1306231394
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Entity Type | Individual
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Provider Name | MARJORIE BRITT KOSSOFF BS, MD
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Gender | Female
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Dates
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Enumeration Date | 04/06/2015
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Last Update Date | 04/06/2015
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Provider Practice Location Address
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Address Line | ROYAL NORTH SHORE HOSPITAL COMMUNITY HEALTH CENTER 2C HERBERT STREET LEVEL 6
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City | ST LEONARDS
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State | NSW
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Zip | 2065
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Country | AU
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Telephone | 61418606909
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Fax |
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Provider Business Mailing Address
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Address Line | 700 PARK REGENCY PL NE APARTMENT 1507
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City | ATLANTA
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State | GA
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Zip | 30326-1271
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Country | US
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Telephone | 404-307-6044
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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 | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number | MED0001135728
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License Number State | ZZ
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Taxonomy #2
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Taxonomy Code | 261QR0206X
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Taxonomy Name | Mammography Clinic/Center
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License Number | 015485
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License Number State | GA
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