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General NPI Number Information
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NPI Number | 1356296909
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Entity Type | Organization
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Legal Business Name | PERFORMANCE MEDICINE PLLC
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Dates
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Enumeration Date | 02/27/2026
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 400 PATROON CREEK BLVD STE 106
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City | ALBANY
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State | NY
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Zip | 12206-5014
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Country | US
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Telephone | 845-612-9439
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Fax |
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Provider Business Mailing Address
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Address Line | 21 BROOKVIEW AVE
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City | DELMAR
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State | NY
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Zip | 12054-3618
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Country | US
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Telephone | 845-612-9439
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MARY DALEY JONES
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Credential | MD
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Telephone | 845-612-9439
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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