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General NPI Number Information
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NPI Number | 1417293325
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Entity Type | Individual
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Provider Name | ANA MIRIAM WELLHOFF RPH
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Gender | Female
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Dates
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Enumeration Date | 12/20/2012
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Last Update Date | 12/20/2012
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Provider Practice Location Address
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Address Line | 21 STANHOPE ST
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City | BOSTON
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State | MA
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Zip | 02116-5111
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Country | US
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Telephone | 617-375-7969
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Fax | 617-375-9656
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Provider Business Mailing Address
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Address Line | 73 PINE ST
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City | NATICK
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State | MA
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Zip | 01760-1207
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Country | US
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Telephone | 508-653-9298
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH22246
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License Number State | MA
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