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General NPI Number Information
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NPI Number | 1376504548
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Entity Type | Individual
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Provider Name | HARRIS MANN
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Gender | Male
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Dates
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Enumeration Date | 03/29/2006
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Last Update Date | 05/01/2008
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Provider Practice Location Address
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Address Line | 207 E FORDHAM RD
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City | BRONX
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State | NY
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Zip | 10458-5014
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Country | US
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Telephone | 718-562-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 40 CROSSHILL RD
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City | HARTSDALE
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State | NY
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Zip | 10530-3013
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 002845
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License Number State | NY
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