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General NPI Number Information
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NPI Number | 1427883446
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Entity Type | Organization
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Legal Business Name | CANSPIREME MEDICAL GROUP LLC
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Dates
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Enumeration Date | 09/09/2024
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Last Update Date | 06/14/2025
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Provider Practice Location Address
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Address Line | 239 MAIN ST STE 2L
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City | WEST ORANGE
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State | NJ
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Zip | 07052-5646
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Country | US
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Telephone | 551-230-3797
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Fax | 551-230-3959
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Provider Business Mailing Address
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Address Line | 239 MAIN ST STE 2L
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City | WEST ORANGE
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State | NJ
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Zip | 07052-5646
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Country | US
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Telephone | 551-230-3797
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Fax | 551-230-3959
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Authorized Official
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Title or Position | CEO
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Name | CANDICE MCEWAN
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Credential | APN
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Telephone | 914-414-6264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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