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General NPI Number Information
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NPI Number | 1376862367
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Entity Type | Organization
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Legal Business Name | NEW FAITH CHIROPRACTIC PC
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Dates
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Enumeration Date | 05/31/2010
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Last Update Date | 05/31/2010
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Provider Practice Location Address
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Address Line | 1010 SUNRISE HWY
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-5100
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Country | US
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Telephone | 516-377-7213
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Fax |
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Provider Business Mailing Address
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Address Line | 1010 SUNRISE HWY
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-5100
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Country | US
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Telephone | 516-377-7213
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STANLEY ANDERSON
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Credential | MD
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Telephone | 718-743-7090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 005743
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License Number State | NY
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