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General NPI Number Information
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NPI Number | 1366522054
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Entity Type | Individual
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Provider Name | WEI ZHANG O.D.
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Gender | Male
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 06/27/2010
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Provider Practice Location Address
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Address Line | 161 CENTEREACH MALL WAL-MART VISION CENTER
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City | CENTEREACH
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State | NY
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Zip | 11720-2750
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Country | US
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Telephone | 631-467-0402
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Fax | 631-585-0425
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Provider Business Mailing Address
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Address Line | 40 MEMORIAL HWY APT 7H
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-8312
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Country | US
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Telephone | 914-355-2794
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV006477
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License Number State | NY
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