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General NPI Number Information
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NPI Number | 1396739512
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Entity Type | Individual
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Provider Name | RAZVAN THEODOR VAIDA M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/02/2005
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 781 FAR HILLS DR STE 600
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City | NEW FREEDOM
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State | PA
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Zip | 17349-9346
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Country | US
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Telephone | 717-812-2560
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Fax | 717-812-2569
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Provider Business Mailing Address
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Address Line | 601 MEMORY LN N/A
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City | YORK
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State | PA
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Zip | 17402-2231
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Country | US
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Telephone | 717-851-1405
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD417666
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License Number State | PA
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