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General NPI Number Information
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NPI Number | 1447076989
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Entity Type | Individual
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Provider Name | ASHLEY LEIMSIDER
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Gender | Female
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Dates
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Enumeration Date | 11/30/2024
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Last Update Date | 11/30/2024
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Provider Practice Location Address
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Address Line | 721 FRANKLIN AVE
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City | GARDEN CITY
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State | NY
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Zip | 11530-4524
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Country | US
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Telephone | 516-394-8029
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Fax |
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Provider Business Mailing Address
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Address Line | 2665 WINDSOR AVE
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City | OCEANSIDE
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State | NY
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Zip | 11572-1144
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Country | US
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Telephone | 516-313-2585
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 1735988231
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License Number State | NY
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