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General NPI Number Information
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NPI Number | 1356342307
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Entity Type | Individual
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Provider Name | JEFFREY BOND PA
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Gender | Male
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 100 GRAND STREET PHYSICIAN RELATIONS
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City | NEW BRITAIN
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State | CT
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Zip | 06050
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Country | US
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Telephone | 860-224-5011
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Fax |
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Provider Business Mailing Address
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Address Line | 100 GRAND STREET PHYSICIANS RELATIONS
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City | NEW BRITAIN
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State | CT
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Zip | 06050
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Country | US
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Telephone | 860-244-5011
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 000999
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License Number State | CT
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