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General NPI Number Information
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NPI Number | 1407779119
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Entity Type | Organization
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Legal Business Name | WOUND CARE MEDICAL OF NY
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Dates
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Enumeration Date | 07/31/2026
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Last Update Date | 07/31/2026
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Provider Practice Location Address
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Address Line | 39 DAVENPORT AVE APT 3E
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City | NEW ROCHELLE
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State | NY
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Zip | 10805-3407
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Country | US
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Telephone | 407-446-3323
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Fax | 917-268-9689
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Provider Business Mailing Address
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Address Line | 39 DAVENPORT AVE APT 3E
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City | NEW ROCHELLE
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State | NY
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Zip | 10805-3407
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Country | US
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Telephone | 407-446-3323
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Fax | 917-268-9689
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Authorized Official
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Title or Position | CEO
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Name | DR. JOSEPH SIDAOUI
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Credential | MD
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Telephone | 407-446-3323
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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