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General NPI Number Information
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NPI Number | 1386935864
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Entity Type | Individual
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Provider Name | JADE ALYSHA DEWITT M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/02/2011
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Last Update Date | 08/03/2020
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Provider Practice Location Address
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Address Line | 3 SYLVAN RD S
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City | WESTPORT
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State | CT
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Zip | 06880-4639
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Country | US
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Telephone | 203-571-0085
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Fax | 203-349-8977
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Provider Business Mailing Address
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Address Line | 3 SYLVAN RD S
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City | WESTPORT
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State | CT
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Zip | 06880-4639
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Country | US
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Telephone | 203-571-0085
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Fax | 203-349-8977
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 56998
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License Number State | CT
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