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General NPI Number Information
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NPI Number | 1386683670
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Entity Type | Individual
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Provider Name | RICHARD CARELLA MD
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Gender | Male
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 08/27/2007
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Provider Practice Location Address
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Address Line | 130 S BRYN MAWR AVE
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City | BRYN MAWR
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State | PA
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Zip | 19010-3121
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Country | US
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Telephone | 610-523-8695
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Fax |
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Provider Business Mailing Address
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Address Line | 1020A E BOAL AVE
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City | BOALSBURG
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State | PA
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Zip | 16827-1509
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Country | US
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Telephone | 814-237-8627
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Fax | 814-238-0083
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | MD829825E
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License Number State | PA
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