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NPI 1316489776

NPI 1316489776 : JAMES MCENTEE : GARNERVILLE, NY

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General NPI Number Information
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    NPI Number           |    1316489776
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    Entity Type          |    Individual 
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    Provider Name        |    JAMES MCENTEE
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/16/2016
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    Last Update Date     |    11/16/2016
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Provider Practice Location Address
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    Address Line         |    46 FOREST DR APT H
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    City                 |    GARNERVILLE
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    State                |    NY
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    Zip                  |    10923-2115
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    Country              |    US
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    Telephone            |    845-362-1255
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    46 FOREST DR APT H
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    City                 |    GARNERVILLE
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    State                |    NY
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    Zip                  |    10923-2115
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    Country              |    US
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    Telephone            |    845-362-1255
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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        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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