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General NPI Number Information
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NPI Number | 1316139991
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Entity Type | Organization
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Legal Business Name | PHYSICAL MEDICINE & REHAB SERVICES LLC
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Dates
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Enumeration Date | 08/16/2007
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Last Update Date | 08/16/2007
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Provider Practice Location Address
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Address Line | 3070 MAIN ST
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City | BRIDGEPORT
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State | CT
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Zip | 06606-4219
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Country | US
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Telephone | 203-371-0433
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Fax | 203-549-0919
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Provider Business Mailing Address
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Address Line | 3070 MAIN ST PVT
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City | BRIDGEPORT
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State | CT
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Zip | 06606-4219
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Country | US
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Telephone | 203-371-0433
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Fax | 203-549-0919
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Authorized Official
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Title or Position | PHYSIATRIST
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Name | DR. BINDU R. CHENNATTU
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Credential | MD
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Telephone | 203-371-0433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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