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NPI 1427601574

NPI 1427601574 : VASILEIOS BOURIS MD, MSC : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1427601574
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    Entity Type          |    Individual 
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    Provider Name        |    VASILEIOS BOURIS MD, MSC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/18/2019
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    Last Update Date     |    07/18/2019
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Provider Practice Location Address
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    Address Line         |    152 E 84TH ST. MANHATTAN
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10028
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    Country              |    US
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    Telephone            |    917-294-8563
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    152 E 84TH ST. MANHATTAN
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10028
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    Country              |    US
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    Telephone            |    917-294-8563
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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        |    390200000X
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    Taxonomy Name        |    Student in an Organized Health Care Education/Training Program
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    License Number       |    
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    License Number State |    
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