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General NPI Number Information
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NPI Number | 1376706820
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Entity Type | Individual
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Provider Name | CAROL A. WEIL O.D., RPT
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Gender | Female
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Dates
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Enumeration Date | 07/04/2008
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Last Update Date | 07/04/2008
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Provider Practice Location Address
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Address Line | 214 LINCOLN ST SUITE 205
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City | ALLSTON
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State | MA
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Zip | 02134-1347
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Country | US
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Telephone | 617-782-0100
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Fax | 617-782-1702
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Provider Business Mailing Address
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Address Line | 214 LINCOLN ST SUITE 205
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City | ALLSTON
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State | MA
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Zip | 02134-1347
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Country | US
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Telephone | 617-782-0100
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Fax | 617-782-1702
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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 | 3553
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License Number State | MA
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