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General NPI Number Information
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NPI Number | 1417249574
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Entity Type | Individual
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Provider Name | FAUSTINE MAI LUU R.P.H
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Gender | Female
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Dates
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Enumeration Date | 05/09/2011
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Last Update Date | 05/09/2011
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Provider Practice Location Address
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Address Line | 7404 METROPOLITAN AVE
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City | MIDDLE VILLAGE
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State | NY
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Zip | 11379-2637
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Country | US
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Telephone | 718-326-3072
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Fax | 718-302-3059
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Provider Business Mailing Address
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Address Line | 8403 133RD AVE
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City | OZONE PARK
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State | NY
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Zip | 11417-1932
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Country | US
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Telephone | 718-326-3072
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Fax | 718-326-3059
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 042918
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License Number State | NY
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