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General NPI Number Information
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NPI Number | 1407109895
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Entity Type | Organization
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Legal Business Name | FORESIGHT GENETICS LLC
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Dates
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Enumeration Date | 10/22/2012
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Last Update Date | 10/22/2012
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Provider Practice Location Address
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Address Line | 1 ROBERTSON DR SUITE #25
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City | BEDMINSTER
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State | NJ
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Zip | 07921-1716
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Country | US
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Telephone | 908-532-0788
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Fax | 908-532-0787
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Provider Business Mailing Address
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Address Line | 16 COLBY DR
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City | BYRAM TWP
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State | NJ
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Zip | 07821-3904
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Country | US
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Telephone | 973-670-9520
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Fax | 973-691-8863
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ELIZABETH ANN COLAIOCCO
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Credential | APN, BC
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Telephone | 973-534-1936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NN08808200
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License Number State | NJ
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