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General NPI Number Information
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NPI Number | 1356596787
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Entity Type | Individual
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Provider Name | PAUL ANDREW GLARE M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/26/2008
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | 1275 YORK AVE
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City | NEW YORK
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State | NY
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Zip | 10065-6007
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Country | US
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Telephone | 646-888-3065
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Fax | 646-422-0937
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Provider Business Mailing Address
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Address Line | 430 E 63RD ST APT 12K
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City | NEW YORK
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State | NY
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Zip | 10065-7918
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Country | US
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Telephone |
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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 | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 258876-1
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License Number State | NY
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