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General NPI Number Information
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NPI Number | 1356597256
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Entity Type | Organization
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Legal Business Name | MAIMONIDES MEDICAL CENTER
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Dates
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Enumeration Date | 08/11/2008
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Last Update Date | 08/11/2008
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Provider Practice Location Address
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Address Line | 555 HENDERSON AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10310-1532
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Country | US
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Telephone | 771-872-0749
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Fax |
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Provider Business Mailing Address
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Address Line | 555 HENDERSON AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10310-1532
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Country | US
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Telephone | 771-872-0749
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | MS. SHARON D. LIPSCOMB
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Credential | 8/2008
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Telephone | 718-720-7498
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 455721-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | F334700-1
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License Number State | NY
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