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General NPI Number Information
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NPI Number | 1407088255
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE ALLERGY & ASTHMA, PC
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Dates
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Enumeration Date | 08/12/2009
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 2209 MERRICK RD STE 202
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City | MERRICK
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State | NY
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Zip | 11566-4770
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Country | US
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Telephone | 516-771-4800
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Fax | 516-771-5950
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Provider Business Mailing Address
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Address Line | 2209 MERRICK RD STE 202
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City | MERRICK
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State | NY
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Zip | 11566-4770
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Country | US
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Telephone | 516-771-4800
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Fax | 516-771-5950
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Authorized Official
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Title or Position | PHYSICIAN / OWNER
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Name | STACEY RADINSKY
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Credential | MD
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Telephone | 516-771-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 220381
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License Number State | NY
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