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General NPI Number Information
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NPI Number | 1326302571
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Entity Type | Organization
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Legal Business Name | CAPITAL DISTRICT PEDICATRICS
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Dates
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Enumeration Date | 07/02/2012
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Last Update Date | 07/02/2012
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Provider Practice Location Address
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Address Line | 400 PATROON CREEK BLVD SUITE 201
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City | ALBANY
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State | NY
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Zip | 12206-5013
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Country | US
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Telephone | 518-438-7086
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 14
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City | GUILDERLAND
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State | NY
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Zip | 12084-0014
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Country | US
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Telephone | 518-438-7086
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. IFEOMA C OJUKWU
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Credential | MD
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Telephone | 843-438-7086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 208353
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License Number State | NY
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