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General NPI Number Information
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NPI Number | 1447406343
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Entity Type | Individual
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Provider Name | LUIS ALBERTO CHAVEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/11/2008
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Last Update Date | 08/11/2008
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Provider Practice Location Address
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Address Line | 1879 MADISON AVE
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City | NEW YORK
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State | NY
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Zip | 10035-2709
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Country | US
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Telephone | 212-423-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 2 W 120TH ST APT 3N
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City | NEW YORK
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State | NY
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Zip | 10027-6352
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Country | US
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Telephone | 212-876-6064
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 51415-020
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License Number State | WI
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