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General NPI Number Information
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NPI Number | 1356806905
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Entity Type | Organization
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Legal Business Name | ANKLE AND FOOT CENTERS OF WESTERN NEW YORK
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Dates
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Enumeration Date | 02/07/2019
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Last Update Date | 08/18/2019
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Provider Practice Location Address
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Address Line | 8745 LAKE STREET RD
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City | LE ROY
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State | NY
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Zip | 14482-9344
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Country | US
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Telephone | 585-297-9761
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Fax | 585-672-9100
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Provider Business Mailing Address
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Address Line | 45 SUMMIT ST
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City | LE ROY
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State | NY
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Zip | 14482-1530
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Country | US
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Telephone | 585-797-5828
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Fax |
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Authorized Official
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Title or Position | FOOT AND ANKLE SURGEON
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Name | GEORGE VITO
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Credential | DPM
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Telephone | 585-297-9761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number |
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License Number State |
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