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General NPI Number Information
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NPI Number | 1376744540
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Entity Type | Individual
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Provider Name | EFRAT YAISH PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 02/13/2014
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Provider Practice Location Address
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Address Line | 530 1ST AVE SUITE 10Q
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City | NEW YORK
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State | NY
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Zip | 10016-6402
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Country | US
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Telephone | 212-263-7021
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Fax | 646-501-0420
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Provider Business Mailing Address
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Address Line | 441 FOSTER AVE BROOKLYN
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City | BROOKLYN
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State | NY
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Zip | 11230-7600
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Country | US
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Telephone | 718-435-0706
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Fax | 646-501-0420
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 008425
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License Number State | NY
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