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General NPI Number Information
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NPI Number | 1356952535
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Entity Type | Organization
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Legal Business Name | MK EYECARE
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Dates
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Enumeration Date | 08/12/2020
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Last Update Date | 08/12/2020
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Provider Practice Location Address
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Address Line | 139 CENTRE ST
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City | NEW YORK
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State | NY
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Zip | 10013-4552
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Country | US
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Telephone | 212-219-2219
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Fax |
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Provider Business Mailing Address
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Address Line | 7010 AUSTIN ST
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City | FOREST HILLS
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State | NY
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Zip | 11375-1021
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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 | OPTICIAN
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Name | KALEENA MA
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Credential |
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Telephone | 715-575-8288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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