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General NPI Number Information
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NPI Number | 1427102326
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Entity Type | Organization
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Legal Business Name | JOHN M BOOZAN MD PA
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 07/26/2010
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Provider Practice Location Address
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Address Line | 33 OVERLOOK RD SUITE 407
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City | SUMMIT
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State | NJ
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Zip | 07901-3570
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Country | US
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Telephone | 908-277-1166
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Fax | 908-277-0141
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Provider Business Mailing Address
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Address Line | 33 OVERLOOK RD SUITE 407
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City | SUMMIT
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State | NJ
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Zip | 07901-3570
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Country | US
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Telephone | 908-277-1166
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Fax | 908-277-0141
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Authorized Official
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Title or Position | PROPRIETOR
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Name | DR. JOHN M BOOZAN
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Credential |
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Telephone | 908-277-1166
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA 46669
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License Number State | NJ
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