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General NPI Number Information
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NPI Number | 1386864585
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Entity Type | Individual
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Provider Name | JOSEPH J BOSCARINO D.D.S
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Gender | Male
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 959 BRUSH HOLLOW RD
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City | WESTBURY
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State | NY
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Zip | 11590-1778
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Country | US
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Telephone | 516-333-6744
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Fax | 516-333-6728
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Provider Business Mailing Address
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Address Line | 5 FOURTH RD
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City | GREAT NECK
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State | NY
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Zip | 11021
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Country | US
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Telephone | 516-829-6069
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 28843
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License Number State | NY
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